It's possible that he doesn't realize he's lying. It seems like he's pathological really. Saying shit like "nobody respects women more than me" and "everybody is going to love this plan, everybody".
On the flip side he knows what people want to hear... half the people anyways. Big promises. Ridiculous promises really, that the non-retarded population sees through and the others buy into without question.
There's no way the healthcare act gets passed. The common sense, or what's left of it, in congress and even the GOP won't let it happen. Not only with 25 million lose their coverage, the middle class will lose thousands in coverage. The average american making 50k a year working full-time had $13.5k (roughly) per year for healthcare, which would now go down to $4k. The rich get to pay less and the poorest will be slammed. Don't forget this middle class working American is the average Trump voter, so let's see how his ratings dive after they realize he's trying to fuck them.