Sometimes you just have to admire the chutzpah of a political party that runs for years on ideological opposition to a beneficial policy, without ever creating a credible alternative that solves the problem. Even on the eve of the Iowa caucuses, Ted Cruz still couldn’t clarify his position on a replacement for the Affordable Care Act. That’s not usually such a big problem for Cruz in an abstract sense, but it became a newsworthy moment of discomfort when a voter with a deeply personal connection to the issue challenged him and still couldn’t get a straight answer:

But at a middle school cafeteria here, a man, Mike Valde, presented him with a tragic tale. His brother-in-law Mark was a barber — “a small-business man,” he said. He had never had a paid vacation day. He received health insurance at last because of the Affordable Care Act. He began to feel sick and went to a doctor.

“He had never been to a doctor for years,” Mr. Valde, 63, of Coralville, Iowa, said. “Multiple tumors behind his heart, his liver, his pancreas. And they said, ‘We’re sorry, sir, there’s nothing we can do for you.’ ”

The room was silent.

“Mark never had health care until Obama care,” Mr. Valde continued. “What are you going to replace it with?”

Cruz then began his usual vapid spiel about how the ACA had supposedly caused millions of job losses (a total lie that the press has been negligent in calling him out on) and skyrocketing premiums (while a small number have seen premiums increase, costs have gone down overall and they certainly haven’t “skyrocketed.”) But he didn’t answer the question.

Normally that would have been that, but the questioner didn’t give up. He kept demanding answer to his question: what would Cruz replace the ACA with?

Mr. Cruz said he was getting there, but had to lay out the problems with the law first. “There are millions of stories on the other side,” he said, describing voters who had liked their insurance plans and lost them because the plans did not provide the level of coverage the new law required.

He went on to describe elements of his plan, which includes an effort to allow people to purchase insurance across state lines.

Mr. Cruz turned back to Mr. Valde. “Your father-in-law, he couldn’t afford it,” he said.

“Brother-in-law,” Mr. Valde said.

“Your brother-in-law couldn’t afford it,” Mr. Cruz said.

“Right,” Mr. Valde said. “But he could afford it — he finally got it under Obama.”

“He would have gotten it earlier, if he could have afforded it earlier,” Mr. Cruz said. “But because of government regulations he couldn’t.”

And that’s where it ended. It’s telling that Cruz never actually answered the question. He declared–utterly without evidence–that government regulations were the cause for high healthcare costs. The only “government regulation” that Cruz and his fellow Republicans can usually ever cite is the inability to sell insurance across state lines. But nearly every industry expert knows that opening insurance to being sold across state lines would be ineffective at best and a disaster at worst, as insurance companies would cherrypick their headquarters in the states with the fewest regulations. Moreover, even in a best case scenario there is an issue with networks: just because you can buy insurance from a provider in a different state, that doesn’t mean you can necessarily access their networks of doctors.

So once again, Cruz failed to answer the question. Instead he overlaid talking points on top of untruths.

That’s not so unusual in politics. But Ted Cruz has made much of his entire reputation on being the purity crusader who shut down the government over his insistence on repealing the Affordable Care Act. One would hope, if he has such passion for the issue, that he would be able to provide at least a fig leaf of an answer for what he would replace with it now that he stands on the edge of the Iowa caucuses in the biggest moment of his political life.

But he can’t. And neither can any of his fellow Republicans, who have voted to repeal the ACA dozens of times without proposing a credible replacement.

It’s the clearest sign of all that the Republican Party, its leadership, and Ted Cruz most of all, have reached total ideological bankruptcy. They’re not even pretending they can govern anymore, or that they have even basic answers for the biggest public policy problems facing the country. Certainly not on issues like climate change or inequality that they simply choose to wave away or ignore, but not even on their own potboiler issues like healthcare and the ACA.

David Atkins

Follow David on Twitter @DavidOAtkins. David Atkins is a writer, activist and research professional living in Santa Barbara. He is a contributor to the Washington Monthly's Political Animal and president of The Pollux Group, a qualitative research firm.