Originally published at Daily Kos

In a presidency largely defined by lies, one pants-on-fire whopper now stands out as Donald Trump’s biggest — and deadliest — yet.

Conservative politicians, pundits and people across the nation loved parroting one of the biggest lies of the Obama era, that — all together now — “if you like your health care plan, you can keep it.”

Yeah, that was a real doozy. In fact, PolitiFact named it “Lie of the Year” for 2013. But Obamacare added 20 million Americans to the ranks of the insured. It saved lives. Trump’s bigger lie flies in the face of reality, a reality in which tens of millions of people will lose coverage, and at least tens of thousands will lose their lives.

On the campaign trail in the fall of 2015, Trump promised to “take care of everybody.”

“Everybody’s going to be taken care of much better than they’re taken care of now,” the billionaire businessman told CBS News. “The government’s gonna pay for it,” he said, raising right-wing eyebrows and ire, as he did when he rightfully praised Canada’s superior universal health care system.

Trump campaigned ferociously against the Affordable Care Act, and after he won, he doubled down on his pledge to repeal Obamacare and replace it with a better, more affordable system that would cover everyone.

“We’re going to have insurance for everybody,” he promised yet again in January.

Enter the American Health Care Act, which House Speaker Paul Ryan (R-WI) said was the product of Republicans keeping their promise to the American people to repeal and replace Obamacare, but which critics from both sides of the political aisle are calling a disaster. Yes, even Republicans — especially Republicans — have been blasting the proposed bill, with Rep. Justin Amash (R-MI) calling it “Obamacare 2.0,” former vice presidential candidate Sarah Palin slamming it as “socialized medicine” and Sen. Tom Cotton (R-AR) even warning the bill might cost Republicans their House majority come the 2018 midterm elections.

All that was before Monday’s report from the nonpartisan Congressional Budget Office (CBO), which estimated that 24 million fewer Americans will have health insurance by 2026, and that premiums would rise sharply in the short term, under the GOP plan.

More importantly, people will die. A lot of people will die. Before Obamacare, a study from Harvard Medical School and Cambridge Health Alliance found that around 45,000 annual US deaths were linked to a lack of health insurance coverage. Harvard Medical School lecturers David Himmelstein and Steffie Woolhandler recently estimated that repealing Obamacare will kill nearly 44,000 Americans each and every year. They based their estimate on the most definitive study analyzing death rates and Medicare expansion, which found that one life was saved for every 455 people who gained coverage. Their excess death estimate is based on 20 million people losing insurance following Obamacare’s repeal. However, based on the CBO figure of 24 million additional uninsured, more than 52,000 people will likely die each year unless the Trump administration takes serious and meaningful action to ensure that everyone covered under the ACA stays insured.

Repealing Obamacare’s individual mandate won’t ensure everyone is covered. Gifting massive tax breaks to the wealthiest Americans — people earning more than $1 million annually will likely save $144 billion collectively under the American Health Care Act — won’t ensure everyone is covered. Health savings accounts, which are as useful to the poor as cookbooks are to the starving, won’t ensure everyone is covered.

Speaking of the poor, it is they, along with the elderly, the mentally ill and the chronically sick, who will suffer the most under the Republican plan. So too, ironically, will millions of people who voted for Trump and who, through ignorance or cognitive dissonance, rabidly rejected Obamacare even while they embraced its more popular provisions.

The only thing that will ensure everyone is covered is what Bernie Sanders calls “Medicare for All,” or what politicians and people in every industrialized nation, and some not-so-industrialized ones, call a basic human right — universal health care. Alas, that remains too hard a sell for even many self-identifying progressives in this country, despite better patient outcomes and lower costs in every other most-developed nation.

And so it is that we take this big step backwards. Gandhi once said that “the true measure of any society can be found in how it treats its most vulnerable members.” Instead of reaching out to uplift and care for them, we Americans have for too long blamed our most vulnerable citizens for their own predicament. Centuries of up-by-the-bootstraps, rugged individualist mythology have blinded us to a reality in which one in six of our fellow Americans is living in poverty in the wealthiest nation in human history, a country in which upward socioeconomic mobility has ground to such a halt that the odds of a poor person rising up into the middle class are the same in Indiana as in India.

Yet we ignore (or are ignorant) of this as we implore our poor to just work harder, and for less pay. Do that, we tell them, and you too can achieve the American Dream — so called, according to the late, great George Carlin, because you have to be asleep to believe it.

We all need to wake up. That’s the best thing we can do to survive the historical regression we find ourselves living in. That, and don’t get sick.