Determined to destroy Barack Obama’s signature health care achievement, Republicans in the US Congress and President Donald Trump have insisted the Affordable Care Act is a failure. If it were a car, it would be “missing two tires, leak gas and have a busted transmission.” The health care system is in a “death spiral.” Americans yearn to be freed from this “nightmare.”

Yet on Friday, as Trump and House Republicans conceded a humiliating defeat and pulled their repeal-and-replace bill minutes before a vote was scheduled, polls showed no such sentiment among American voters.

A Kaiser Family Foundation survey showed 51 percent of Americans don’t want a repeal. A Quinnipiac poll showed only 17 percent of voters want the Republican replacement. Not even a majority of Republicans liked the awful plan cooked up by the House, which would have left 24 million people uninsured over the next decade.

Why the disconnect? Maybe because the existing system, while flawed, isn’t a disaster. Maybe because Americans -- who mostly get health insurance through their employers -- don’t mind that 20 million of the less privileged among us can finally afford health care.

Maybe because what’s collapsed is the construct of lies Republicans used to undercut Obamacare.

Somewhere on the cutting room floor there probably is an honest debate to be had about whether Americans care about each other’s health and how we should pay for it if a healthy populace is important. And somewhere in that debate, there’s a truthful conservative argument for repealing Obamacare.

If so, it probably sounds like the Freedom Caucus, which threw a monkey wrench into the Republican replacement plan this week by insisting it be stripped of any mandate requiring collective support for society’s collective well-being.

Helping each other ought to be an option, not a law, the Freedomites feel. For them, it wasn’t enough that the first draft of the Republican replacement would have yanked health insurance from 14 million people next year to bestow a huge tax cut on the rich.

They wanted to hasten that tax cut, halving the original plan’s deficit reductions. They wanted to ax provisions requiring coverage of pre-existing conditions and inclusion of children up to age 26 on their parents’ policies.

They wanted states to be able to impose work requirements on Medicaid patients, and force new mothers to get back to work within two months of child birth. They wanted to strip the measure of key safeguards requiring insurers to cover health care essentials -- emergency services, wellness visits, rehabilitative services, maternity care, addiction treatment and mental health care.

Conservatives want an end to “health benefits that force an older, teetotaling couple to have to purchase coverage for drug rehabilitation and pediatric care,” as Rep. Tom McClintock, a Republican from California -- whose own congressional coverage is top-of-the-line -- put it. But pooled risk is the basis not only for civil society, but insurance.

The far right is entitled to its opinion, but the truth is, most Americans disagree with it.

It’s anyone’s guess what ultimately will happen to the Republican alternative to the Affordable Care Act. Trump -- who, incredibly, tried to blame Democrats for a failure that belongs to him and the Republican-controlled Congress -- is trying to administratively gut it. And, though House Speaker Paul Ryan mourned Friday that Obamacare will remain the law “for the foreseeable future,” his caucus has hated it for too long for their dream of its death to entirely go away.

But politically, Trump, Ryan and House Majority Leader Kevin McCarthy should think hard about the recklessness and dishonesty with which they have approached this life-and-death issue.

“Repeal-and-replace” would not, as Trump has claimed, produce “a beautiful picture.” It would not end some imaginary “nightmare,” as Ryan keeps insisting. There are good reasons why everyone from hospitals to retirees to some Republican governors opposed it.

Voters want improvements in health care, but nobody likes to be lied to. Go back to the drawing board, Congress. And don’t come back until you have a bipartisan plan that’s reality-based.


Editorial by The Sacramento Bee