As I said elsewhere on the thread, this rebuttal proves too much; unless you're really saying that it's structurally impossible due to the US Constitution or our unique culture to have decent health care, you'll have to do better than "anything the Democrats pass, the Republicans will try to repeal".
you'll have to do better than "anything the Democrats pass, the Republicans will try to repeal"
It's not that, though there's some element of it in there. It's much more complex than that and I think a huge amount of it is driven by internal fractures within the Republican party even though legislatively they've seemingly been moving in lockstep. Without the branding most of the components of the ACA are or were fairly popular or at least understood/accepted by a big chunk of Republican voters (e.g. Kynect), but there's a big enough subset that are opposed to make the politics within the party such that anyone voicing approval couldn't get enough votes to remain in office.
The long-term impact is that killing off the compromise system that is the ACA is going to make it more likely that the USA will go to some form of single-payer or hybrid system with a single-payer level and private insurance for extended options (much like Medicare + Medigap). I think if the Republicans had succeeded in killing it off in 2017 we'd probably be looking at something like Medicare expansion starting around 2023, if they do it now I'd figure that might still be the case but it may be extended out to 2025 for the starting point. Whether it's something completely new or simply an expansion of "You can buy into Medicare" to ever-earlier ages is too soon to tell.
It's hard for me to understand how the ACA can be perilously insecure due to legislative pressure from the GOP, but single payer would not be. The ACA is a conservative health policy.
That is a very true argument, which is why I expect anything in the future on this to be an expansion of Medicare instead of something completely new.
The ACA being a conservative health policy matters relatively little because it's not the ACA that's being targeted - it's "Obamacare." [edited out a ton of crap you likely already know if you care to] Basically it's not the policy that matters, it's who passed it.
