The difference between a stable ACA and a wobbling or downward-spiraling ACA, in other words, isn’t the destroy-the-village-to-save-the-village provisions of the American Health Care Act, but quantifiable sabotage by Republicans running the federal government.

In a way it’s some kind of miracle that the ACA ever clawed its way to popularity, or that the AHCA is so much more unpopular than the ACA ever was.

You would never know this if you were basing your views of the AHCA, and the purposes it’s meant to serve, on the ambient media environment. Amy Walter of the Cook Political Report tallied up TV advertising for and against the ACA in 2010, and for and against the AHCA today, and her findings are extremely revealing. While opponents of the AHCA have aired more ads than proponents of the AHCA, the ratio is a not-terribly-lopsided 57 percent to 43 percent. Back in 2010, the ACA was swamped by an opposition campaign that out-advertised ACA supporters by a 9-to-1 margin.

In a way it’s some kind of miracle that the ACA ever clawed its way to popularity, or that the AHCA is so much more unpopular than the ACA ever was.

The history of the ACA, and the Clintoncare efforts of the early ’90s before it, show us that the health care industry knows how to fight and even defeat legislative efforts that threaten what they perceive to be their interests. Wilson speaking out bluntly is useful for journalistic purposes, and for his own interest in leveraging the Trump administration, but underscores just how timid the broader industry has been in the face of a multifaceted assault on a flawed but fixable insurance market. Insurance companies may not pine for the pre-Obamacare status quo, but they apparently don’t want to ruffle the feathers of the leaders of a unified government, especially a retributive president who could train his sights on them.

We have seen no profusion of Harry and Louise–style scare ads warning the public of the chaos Republicans are threatening to unleash in American health care, either by passing the AHCA or freezing cost-sharing payments to bring about the ACA’s collapse.

To the contrary, the opposition to the AHCA appears to be an outgrowth not of industry advocacy, but of news reports and consumer backlash to non-partisan analyses of the bill, which show it would uninsure over 20 million people and eliminate protections for people with pre-existing conditions in many parts of the country. There is no death-panel style agitprop for Republicans to contend with, so instead they are able to deploy agitprop of their own, including to neutralize the dispassionate findings of the Congressional Budget Office.

Last week, the Department of Health and Human Services—the department that is supposed to administer the ACA—counter-programmed CBO with an anti-Obamacare propaganda paper purporting to show premiums have soared under the ACA, without accounting for the fact that ACA plans are regulated to cover essential services, and subsidized to shield beneficiaries from premium increases.

Senator John Cornyn, a member of the GOP leadership and the tight-lipped working group modifying Trumpcare behind closed doors, called numbers pulled directly from the CBO’s report “fake news.”

In attempting to swindle Trumpcare into law, Republicans have relied on more than just false pretenses. They have sought to corrupt and discredit arms of government that were established to fight false pretenses with truth. It is another scandal marked by secret meetings, violated norms, collusion, and deceit. The public is outraged about it. But most of Washington has decided not to care.

