National

“I take it as an insult, and I will not lie down and say people can call me dishonest, misleading or misrepresenting,” he said, dismissing his critics as “hacks and haters.” Presumably in jest, Mr. Paul added: “If dueling were legal in Kentucky, if they keep it up, it’d be a duel challenge.”

With Obamacare, a small number of people lose their current insurance but they end up with alternative, typically stronger coverage. Under the plans Republicans have endorsed, a larger number of people would lose their current insurance, as people migrated to a more volatile and less secure marketplace. Under Obamacare, the number of Americans without health insurance at all will come down, eventually by 30 or 40 million. Under most of the Republican plans, the number of Americans without insurance would rise. Honest Republicans would justify their policies by arguing that Medicaid is a wasteful, inefficient program not worth keeping—and their changes, overall, would reduce health care spending while maximizing liberty. In other words, forcing people to give up their coverage is worth it. I don’t agree with those arguments, but they are honest. But they should stop pretending that it’s possible to address the problems of American health care without disrupting at least some people’s insurance arrangements—because, after all, they want to do the very same thing.