Paul Ryan is a liar, but you knew that.
The big lie in this clip is he said Medicaid didn't reach coverage goal WITHOUT MENTIONING Republican states refused to expand Medicaid. That refusal is almost entirely responsible for Medicaid not reaching its coverage goals under the Affordable Care Act.
As the Kaiser Family Foundation points out, there IS a coverage gap "that results from state decisions not to expand Medicaid, meaning their income is above current Medicaid eligibility but below the lower limit for Marketplace premium tax credits. These individuals would have been newly-eligible for Medicaid had their state chosen to expand coverage."
And then he complains that if you're on Medicaid, you can't find a doctor who will treat you.
BUT...to another questioner he said "federal health centers" would be a terrific alternative to Planned Parenthood care, which he wants to defund because abortion.
Newsflash, Speaker Ryan: One of the qualifications healthcare centers need to meet for federal standards is they MUST take Medicaid, Medicare, Veterans, and other government health insurance, and offer services to all persons, regardless of the person’s ability to pay (which also means a sliding scale for payments). If federal health centers are adequate to "replace Planned Parenthood", (and how dare you) they're adequate to provide care to Medicaid patients. If they're not, you're lying again.