They say a gaffe in Washington is when you accidentally tell the truth. If so, former President Bill Clinton just had a big gaffe concerning President Barack Obama’s signature achievement.

On Monday, former President Clinton told an audience at a rally for his wife’s presidential candidacy that the Affordable Care Act (popularly known as Obamacare) was terrible for middle class Americans because they are penalized for not qualifying for government support. Clinton said:

[T]he people that are getting killed in this deal are small businesspeople and individuals who make just a little too much to get any of these subsidies. Why? Because they’re not organized, they don’t have any bargaining power with insurance companies, and they’re getting whacked. So you’ve got this crazy system where all of a sudden, 25 million more people have healthcare and then the people that are out there busting it—sometimes 60 hours a week—wind up with their premiums doubled and their coverage cut in half. It’s the craziest thing in the world.

Not surprisingly, Bill Clinton’s characterization of Obamacare as “crazy” was seized upon by the Trump campaign and other critics to further the case against the ACA.

Clinton later tried to walk back his comments and noted, correctly, that he had limited his criticism of the ACA as “crazy” to that one aspect of the bill. Clinton had also praised other aspects of Obamacare, such as making it illegal for insurance companies to deny coverage based on a customer having a preexisting medical condition.

But Clinton should have committed another gaffe and told people the truth that Obamacare is failing. The system simply can not continue on as is for much longer.

The reasons Obamacare is failing were not only predictable, they were predicted. Insurance companies are leaving the exchanges en mass because they can’t make a profit or even break even (the so-called “death spiral”). They have already dropped cheaper popular plans due to regulations. Instead of having more choices, consumers have fewer.

In Arizona, every county but one will have only one choice for private health insurance.

The underlying problem for all of this was perfectly articulated by Senator Bernie Sanders in the primaries. The private insurance system relies on denying care and the only solution to achieve the goal of universal coverage is a single-payer system—a system that more closely mirrors the rest of the developed world.

This proposal was continually mocked by Hillary Clinton, who claimed Sanders was trying to dismantle Obamacare and take care away from people, which was a genuinely ridiculous attack. Clinton stopped making it after being repeatedly criticized for being dishonest.

But it looks like Obamacare will be dismantled one way or the other. The system is failing and will either be repealed after increasing public outrage, or, as Sanders suggested, replaced with a universal system that will cover everyone. While Clinton may have scored some points smearing Sanders in the primaries, it looks as though Bernie will have the last laugh on progressive policymaking.

Either the US adopts a universal single-payer system or it accepts a brutal classist system where the rich get well taken care off and everyone else lives on the knife’s edge. There is no third way.