In their final televised debate ahead of the November midterms, U.S. Rep. Peter Roskam of Wheaton and Democratic challenger Sean Casten tussled over a wide range of disagreements and accusations, but one about health care policy stood out.

Roskam, seeking a seventh term in his west suburban district, was asked by debate moderator Carol Marin of WTTW to reconcile repeated votes to repeal Obamacare with his claim that he strongly supports insurance safeguards for those with pre-existing conditions.

"Well, like many people have said, let’s take the good things out of it and embrace those and shun the bad things. And that’s exactly what we did," Roskam responded, referring to a Republican substitute for Obamacare that was narrowly defeated. "Sean has falsely accused me of being against protecting people with pre-existing conditions, and that was fact-checked by the Washington Post who gave that four Pinocchios."

Did fact checkers at the Washington Post indeed side with Roskam? And has Roskam always championed those pre-existing protections, as he claimed?

The short answer is "no." No such fact check exists. PolitiFact and Washington Post fact checkers have also determined that the Republican health plan Roskam backed would have weakened protections for people with pre-existing conditions.

The longer answer involves a concerted effort by several congressional Republicans, as well as President Donald Trump, to misleadingly recast the GOP as defenders of one of the most popular elements of the very health care law that they have attempted to dismantle for years.

Playing with Pinocchios

First a word about Pinocchios. Our friends at the Washington Post’s Fact Checker use a different rating system than PolitiFact’s "Truth-O-Meter" to measure degrees of distortion and mendacity, with Four Pinocchios being the worst rating someone can receive.

"Egad," was the initial response from Glenn Kessler, the Post’s lead fact checker, when we notified him about Roskam’s claim to have been exonerated by the paper.

Kessler told us no such fact check exists. At the same time, he pointed to recent Four Pinocchio ratings he had given to Rep. Jeff Denham, a Republican from California, and Rep. Dave Brat, a Virginia Republican, for making essentially the same claim Roskam made.

Since we first contacted Kessler, he has told followers on Twitter that at least three other Republican House members have joined Denham, Brat and Roskam in repeating the false assertion, among them Rep. Rodney Davis, who is locked in a tight re-election battle in the central Illinois 13th District.

Kessler called them all out on Twitter following our inquiry. "Lawmakers, if you voted for AHCA, defend your decision, but do not try to hide behind our Pinocchios," he wrote after quoting Roskam specifically.

[From the Washington Post: These Republicans are misleading voters about our Obamacare fact checks]

In support of Roskam’s claim, the Republican’s campaign pointed us to a Washington Post fact check of a statement from Democratic Sen. Kamala Harris of California that took her to task for significantly inflating the number of people with pre-existing conditions that would be put at risk by the GOP plan, called the American Health Care Act. It passed the House but died in the Senate last year.

That’s the same fact check Denham erroneously cited.

Nowhere does the piece about Harris credit the Republican substitute health plan backed by Roskam and the others with protecting pre-existing conditions. Indeed, Kessler authored a more recent piece likening the GOP pledge to protect pre-existing conditions to former President Barack Obama’s unsustainable promise that under Obamacare, "if you like your plan, you can keep it." In 2013, PolitiFact named that Obama promise its Lie of the Year.

PolitiFact recently revisited the pre-existing condition coverage debate, explaining why Republican proposals on pre-existing conditions are inferior to those contained in Obamacare.

Like Obamacare, the GOP plan guaranteed that those with pre-existing conditions could not be denied coverage outright. But it would allow for insurers to charge some with pre-existing conditions significantly more for coverage, potentially making policies too expensive to afford.

Our ruling

Roskam said his Democratic opponent had falsely accused him "of being against protecting people with pre-existing conditions, and that was fact-checked by the Washington Post who gave that four Pinocchios."

No such fact check exists.

Roskam’s campaign did point us to a fact check of a claim made by a Senate Democrat that greatly overestimated the number of Americans with pre-existing conditions who might not be able to access coverage if Obamacare were replaced by GOP substitute.

But that fact check had nothing to do with Roskam or his stance. Roskam voted for the substitute, which would have weakened the pre-existing condition protections of Obamacare.

We don’t hand out Pinocchios, but we have a similar measure for whoppers like Roskam’s. We rate it Pants on Fire!