It isn’t time for the Democrats to gloat. They have had a small victory in Congress, the Trump healthcare repeal was pronounced dead on the floor. That wasn’t a victory for the Democratic values, but a victory for the New Democrats, the ACA is a Republican style band-aid that never attempts to change the fundamental values of the modern Democrat-lite party. Obama accepted the values of the business world, in particular the values of our corporate style hospital system. Obama also had close connections to the medical industry. Michelle Obama worked for the University of Chicago Medical Center and Rahm Emanuel’s brother Ezekiel is an oncologist who is also a professor at the University of Pennsylvania.
The ACA took the approach of easy fixes. For example it let the children of the better off buy into their parents healthcare plans rather than paying for their own on the individual market. So, instead of having more young people contribute to the individual market pool, it contributed to the employer market, making premiums higher for those people who were new to the individual market. The only true solution is a national plan (or set of regional plans) that takes over for the employer market. That would be difficult because so many companies would want to keep salaries where they are after giving up the cost of healthcare. We need price controls. The Europeans do this through negotiation. We need to eliminate the fee for service system, which creates incentives to boost prices. Many in the medical industry would ultimately accept this since it would end uncovered care that burdens so many hospitals.
The GOP will probably come up with an ACA killer law, it won’t be easy, but it is doable if the hinterland caucus (aka freedom caucus) can be neutered.