I realize this is not a helpful answer and highlights a problem
with a two party system, but the problem is that the fix is not easy. It requires hard, unpopular decisions. Namely that if we're going to provide coverage to everyone, including people with pre-existing conditions, we have to get EVERYONE into the risk pools, and everyone PAYING into the risk pools, be it via premiums or via a meaningful, enforceable penalty.
So from a political standpoint, you can't let the Dems pass a plan that has mostly good stuff (insurance for everyone, subsidies for many, coverage for pre-existing conditions), but very little bad stuff (meaningful penalties with teeth to force everyone into the pools). And as much as I have no use for the republican party these days, I don't blame them for not wanting to be the ones to make the hard, unpopular decisions to actually shore up the ACA. I promise you, if they did that, and even if it was a huge success, they'd get the shit beat out of them by democrats at the polls in november saying "[cue sinister music] those mean, evil republicans raised your penalty by 500%..." or something to that effect. And it would work.
What I don't understand is why the GOP even went down the path of trying to fix it. They know there are no "easy" fixes so it's really only downside for them. If there were easy fixes, the dems would have included those fixes in the original plan. The flaws with the ACA that made it initially (somewhat) popular are starting to make it less and less popular as bad risk pools are pricing more and more people out.
The answer will eventually be universal healthcare. But that will be a total mess to implement and get right so I hope we allow private pay options to co-exist if and when we do go to universal healthcare.
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In response to this post by KCHoo)
Posted: 07/18/2017 at 07:20AM