Republicans think they can win on health care in 2020 by running against Medicare for All, and the facts about single payer are a target-rich environment. But the latest data on ObamaCare shows why the GOP needs to come up with its own ideas to sell to the public.

The Centers for Medicare and Medicaid Services this week released a report on trends in the individual health insurance market, and the results are ugly. Of particular note is the continued flight of those who aren’t entitled to the Affordable Care Act’s tax-credit subsidies and thus are exposed to the full pain of high premiums. The tax credits phase out at about $100,000 for a family of four. In other words, the American middle class.

From 2016 to 2018, enrollment among those who didn’t qualify for subsidies dropped by 2.5 million people—a 40% decline nationally. Average monthly enrollment across the entire individual market fell 7% between 2017 and 2018. CMS says the decline occurred “entirely” among people who didn’t receive subsidies. For those who get taxpayer help, enrollment increased 4%. Remember that the law’s tax credits increase with premiums, and thus so does the strain on the public fisc.

CMS notes the escape from the market is far more pronounced in some states. Over the same two-year period, unsubsidized enrollment dropped by an astounding 91% in Iowa, 79% in Arizona, 78% in Nebraska, 76% in Tennessee, and 71% in Georgia and Oklahoma.

All told, CMS says the subsidized portion of the market was 122% larger than the unsubsidized market in 2018, up from 61% in 2017. In other words, ObamaCare plans are increasingly valuable only to those who receive cash transfers to buy it.