The whole ACA act was supposed to be a temporary bandaid on our healthcare crisis., according to Obama himself (actualyl he said it was supposed to be just the 1st step in long process).
Little did Obama know, that no progress would be possible...for the whole country...its been a slow dive down the sewer since.
OVder 10 years later, Republicans have finally privately admitted that repealing the ACA would be political suicide cause their constituents rely on the support granted in the ACA (whether they realize it or not). But rather than take advantage of the Republicans slow reckoning, the Democrats have done precisely nothing to expand the ACA, and have spent all their time failing to defend the ACA from being eroded by the constant attacks of Republicans.
Both parties disgust me here. The American people want universal healthcare coverage, something like 67% want a medicare for all system. And we're not getting it because the Democrats and Republicans dont give a damn what the American people want, they only serve corporate interests like insurance companies or possibly hostile nations pretending to be allies like Israel (which does have Universal Healthcare coverage for its citizen, btw).
This shutdown is about who is gonna be scapegoated for the refusal of our elected government to put the interests of the American people ahead of the interests of the health insurance companies.
Universal healthcare wasn’t politically possible in 2010, and still isn’t. The Democrats wisely believed that getting half a loaf is better than no loaf. So the ACA was formed (and was a Republican idea in 1989.)
Affordable Care Act (ACA), was a three-legged stool of regulations and subsidies. The three legs represent the three essential components needed for the ACA to function: a mandate requiring people to buy insurance, community rating or non-discrimination provisions, and subsidies to make coverage affordable for lower-income individuals.
The way the ACA works is that insurance companies are prohibited from discriminating based on medical history — they have to offer the same plans, at the same prices, to healthy people and less healthy people. They can’t charge you more if you have a preexisting condition. The goal of that prohibition is to make sure that health care is available and affordable to those who need it most.
Suppose you want to guarantee that insurance is available to people with pre-existing conditions. Well, you can establish community rating, requiring that insurance companies make the same policies available to everyone. But if you stop there, you know what will happen: healthy people will opt out, leaving behind a high-risk, high-cost pool.
So you have to also have a mandate, requiring that people buy insurance. And you can’t do that without subsidies, so that lower-income people can afford their policies.
Trump cut off one leg in his first term, the requirement to buy insurance and the ACA still survived, losing the uninsured rate to the lowest it’s ever been.
The original, 2010 version of the ACA was, however, underpowered. The subsidies were too small, and they cut off suddenly for people whose income rose above a relatively low threshold (400 percent of the poverty line.) What the Biden administration did was to make the subsidies more generous and also end the cutoff.
Now comes the key point: Biden had very limited political room for maneuver, since he only had 50 Senators and couldn’t afford to lose a single vote. So he was constrained by the most conservative Democrats — basically Joe Manchin — and while Manchin was willing to expand the ACA subsidies, he did so only on a temporary basis, extending through 2025. Now the enhanced subsidies are about to expire, and the financial hit to many Americans will be apocalyptic.