In a speech in Florida today, Mitt Romney repeated his frequent claim that in a post-ObamaCare world, he would fight to prevent insurance companies from denying coverage to people with pre-existing health conditions.

That’s not just a lie, but a pretty big, pretty important lie.

First off, when Romney talks about protecting insurance coverage for people with pre-existing conditions, he’s talking about those with “continuing coverage”–i.e., those who quit jobs with employer-based health insurance. But they are already “protected” under current law, if you consider “protection” the “right” to buy crappy, overpriced HIPAA policies, or to temporarily continue old policies via COBRA (which involves paying employer as well as employee premiums)

Challenged with these facts, Team Romney once again changes the subject from federal guarantees to the alleged ability of states to provide “high-risk pools” (again, available under existing law, and providing crappy, expensive coverage) and/or to use the new flexibility Mitt and Paul Ryan want to give them to cover whoever they want under a Medicaid block grant. I’m just sure they will choose to focus on that problem even as Mitt and Ryan slash federal funding for Medicaid, threatening the eligibility of millions of poor and disabled folks who are Medicaid’s core responsibility.

But so far critics of Romney’s health care plans haven’t focused much on another disaster he would create for the un- and under-insured: his support for interstate insurance sales, which would almost certainly destroy existing state regulation of insurers, who would be able to stampede to whatever state offered them the opportunity to deny coverage and make premiums strictly dependent on health conditions.

So it’s not just a matter of Romney denying the wisdom of his own health care plan in Massachusetts (which depended, BTW, on the kind of generous federal Medicaid subsidies his and Ryan’s budget proposals would make a thing of the distant past) and offering dishonest and threadbare “solutions” to the problem of pre-existing conditions and other shortcomings of the status quo ante. By supporting interstate insurance sales and major reductions in federal Medicaid funding and (for dessert) the herding of people now covered by employer-based policies into the individual market, Romney would make the coverage and affordability problems far worse than they were in 2010. I know I’m becoming a broken record on the subject, but it’s important to understand the GOP’s agenda for health care is not “repeal and replace,” or even “repeal and do nothing”–it’s “repeal and reverse,” and a cruel trick on anyone looking for genuine reform.

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Ed Kilgore is a political columnist for New York and managing editor at the Democratic Strategist website. He was a contributing writer at the Washington Monthly from January 2012 until November 2015, and was the principal contributor to the Political Animal blog.