It’s a persistent Democratic talking point. It’s almost always mentioned by opponents of Brett Kavanaugh, Donald Trump’s choice to be on the Supreme Court. It’s the number one argument Democrats make for why they, rather than Republicans, should be trusted with the health care system.

Anyone with a pre-existing condition is at risk, they say. If Republicans have their way and you’re sick, you’ll face higher premiums, skimpier coverage and perhaps no insurance at all.

So, how did Republicans become vulnerable to these kinds of charges? Because they are partly true.

Obamacare is essentially private-sector socialism. Healthy people are forced to pay more than actuarially fair premiums so that sick people can pay less. And virtually every important change to Obamacare made by the Republican Congress and the Trump administration has been designed to give relief to the healthy.

Abolishing the individual mandate, allowing people to join association health plans, making it easier to buy short term insurance not bound by Obamacare regulations – all these measures allow the healthy to escape their unfair premiums. If another run at challenging the constitutionality of the entire Obamacare law is successful, that would also let healthy people escape.

All these changes are good. But if the healthy leave, what happens to the sick?

With fewer healthy people paying into the insurance pool, there is less money to subsidize those who remain. That gives Democrats the opportunity to stoke fear in the minds of anyone with a chronic health condition.