Both Bill Clinton and Barack Obama struggled to overcome widespread and persistent myths about their proposals to reform the American health care system. Their difficulties highlight the influence of factual misinformation in national politics and the extent to which it correlates with citizens' political views. In this essay, I explain how greater elite polarization and the growth in media choice have reinforced the partisan divide in factual beliefs. To illustrate these points, I analyze debates over health care reform in 1993–1994 and 2009–2010, tracing the spread of false claims about reform proposals from Bill Clinton and Barack Obama and analyzing the prevalence of misinformation in public opinion. Since false beliefs are extremely difficult to correct, I conclude by arguing that increasing the reputational costs for dishonest elites might be a more effective approach to improving democratic discourse.