Take, for example, the response to news earlier this week that 6.4 million people have signed up this year for health insurance coverage under Obamacare. That number doesn’t include the millions of Americans who will be automatically renewed in plans or some of the individual health exchanges like California and New York. In all, an estimated 13.8 million people will have been signed up for coverage through Obamacare when the open-enrollment period concludes at the end of January. Then there are the more than 12 million who have benefited from Medicaid expansion. Big success, right? Not according to Speaker of the House Paul Ryan.

While I’m generally loathe to invoke Nazism in a discussion of American politics (and I’m not comparing Republicans to Nazis), I’m hard pressed to think of a better description of the Republican Party’s shameless and incessant dishonesty when it comes to Obamacare. Republicans aren’t simply manipulating the truth or exaggerating — they are straight-up lying.

THE NAZI PROPAGANDIST Joseph Goebbels once famously said, “If you tell a lie big enough and keep repeating it, people will eventually come to believe it.”

“This disaster of a law has led to massive premium spikes, less choice for patients, and a collapse of the exchange markets, and no amount of spinning from the White House can hide this ugly reality,” said Ryan’s spokesman, AshLee Strong.


Disaster is a word you often hear in describing Obamacare. Monstrosity is another. But how can those words describe a law that has expanded access to more than 20 million Americans and according to some estimates, in Ryan’s home state of Wisconsin, dropped the uninsured rate in half?

It’s true that some insurers have left the exchanges, and that’s given consumers fewer options for buying coverage. It’s also true that overall premiums on Obamacare exchanges will increase by 25 percent in 2017. However, if 6.4 million people have signed up for coverage, it’s pretty clear that (a) the exchanges are not collapsing and (b) consumers aren’t being dissuaded by higher premiums and fewer choices. And since between 85 and 90 percent of Obamacare buyers receive government subsidies, the “massive spike” in premiums will be cancelled out by that assistance.


On the employer side, which is how most Americans receive health insurance, premiums have actually increased by a lower percentage than they did before Obamacare became law. Of course, Republicans still argue the opposite.

But here’s the more important thing to remember: Republicans want to repeal the Affordable Care Act. So one has to compare their critique of the law with the way things were pre-Obamacare, when millions of Americans could not buy insurance because of preexisting-condition obstacles or because it was prohibitively expensive. To suggest that American health care today is worse than it was then is provably untrue.

These are hardly the only lies that Republicans tell about Obamcare. Ryan has said “because of Obamacare, Medicare is going broke.” In fact, Medicare is in better shape than before the law was passed — and would be significantly imperiled by repeal.

Senate majority leader Mitch McConnell claims that Obamacare caused “chaos” in the private insurance market. Anyone who tried to buy insurance in the individual market before Obamacare knows this is not true. By the way, in McConnell’s home state of Kentucky the uninsured rate has dropped by 11 points since 2013 — the second largest decline in the country.


Bill Cassidy, a Republican senator from Louisiana, as well as being a physician, recently said that Obamacare has made the opioid epidemic worse. His argument is that, because of the mandates the law imposed on employers to offer care to their workers, fewer people had jobs, thus increasing despair and more drug use. This of course is nonsense.

In just the state of Pennsylvania, more than 65,000 people have been enrolled in drug and alcohol treatment programs because of Obamacare. But Cassidy’s comments are emblematic of the Obamacare derangement syndrome that has overtaken Republicans — they can’t recognize the law’s benefit and use it as a catch-all explanation for everything wrong in American health care

This is one of the great ironies of the GOP’s Big Lie on Obamacare. They’ve so convinced themselves that the law is a disaster that they are preparing to repeal it — based not on evidence, but on their fantastical understanding of what Obamacare has wrought. What’s not fantasy, however, are the 20 million to 30 million Americans who will lose their coverage or be unable to afford it because of repeal — and then blame Republicans for taking it away. In the end, the Republicans’ dishonesty on Obamacare is about to give them a healthy dose of reality.

Michael A. Cohen’s column appears regularly in the Globe. Follow him on Twitter @speechboy71.