The Affordable Care Act has not worked as advertised. That is the fundamental fact around which the debate should be organized. The ACA did not result in lower premiums but in the opposite; it did not result in more competitive insurance markets but in the opposite; it did not result in superior health-insurance plans but, at least in many cases, the opposite; it has not resulted in universal coverage. Among the major promises made on behalf of the ACA, only one of any significance has been delivered on: It is the case that more Americans have health insurance today than they did in 2009. But the ACA has underdelivered on that point, too.But that's excusable, because Good Intentions, and Evil Objectors.
The defects of the ACA are plain for all to see. Everybody knows what they are. But what has been the Democratic response to attempts to fix them? Screeching that Republicans are cruel, that they hate poor people, or that they are influenced by obscure financial motives. What those financial motives might be is not obvious: The biggest financial players in the health-insurance industry, the insurance companies themselves, generally supported ACA and generally opposed recent Republican reform efforts, especially the repeal of the mandate that obliges every American to buy the products the insurance companies sell. And the insurance companies like the Democrats’ current big idea on health-insurance reform: burying the insurance companies in bailout money to cover up the problems created by the ACA.He continues, "The ACA does not work." And the attrition continues.
This situation sometimes results in amusing developments: When Graham-Cassidy was being debated, progressives circulated a list of industry groups opposed to it — as though deferring to corporate interests were self-evidently good policy from a progressive point of view. It’s part of an argument that, in total, doesn’t make any sense — “Corporate special interests want to stop Republicans from selling the People out to corporate special interests!” — but the argument isn’t about the argument. It’s about pointing to the other side and shouting: “Bad!” If you think about it, Donald Trump hasn’t invented a new kind of politics but has simply stripped our existing political discourse down to its fundamentals.
How far must the unraveling go until our political masters consider trade-tested betterments?