One problem in having a president who operates without much regard for facts, truth or consistency – one whose staff has devised the concept of “alternative facts” – is that when he says or promises something, no one can know whether he means it. So it was with President Trump’s mid-January promise of “health insurance for everybody,” including better coverage, more choice among policies, lower deductibles and no one left behind – far different from anything his Republican allies in Congress ever promised in their many efforts to “repeal and replace” Obamacare, the Affordable Care Act .