The fate of Paul Ryan’s American Health Care Act hangs in the balance today, as House leadership — backed by the White House — has declared an end to debate and negotiation, and is simply asking wavering members to put up or shut up at a vote scheduled for Friday afternoon.

This would normally be a time of frenetic presidential activity working the phones and talking to recalcitrant members, but Donald Trump has added a new element to the mix — tweets:

The tweet about “skyrocketing premiums & deductibles, bad health care” is emblematic of the years-long campaign of lies about health care policy that has brought the Republican Party to this point. It is 100 percent true that under the Affordable Care Act both premiums and deductibles are higher than people would like, and also that patients have less choice of health care providers than they would want. If you want to make politically popular criticisms of the law, these are smart things to point to.

The problem for Republicans is that, while you certainly could write a bill that solves those problems, they have written a bill that does the reverse. They’ve pulled hundreds of billions of dollars out of health care to cut taxes for high-income families, leaving people with higher premiums and deductibles and less choice than ever.