UPDATE: FYI, in conjunction with this diary I wrote a second one to show how insurers actually benefit when health CARE providers increase their prices: Do insurers have an incentive under the ACA to let health costs rise? YES, and I'll show you why.

I was reading a few diaries on the rec list recently, one is by front pager Jen Hayden called

Republican congresswoman's poll on repealing Obamacare didn't quite go as planned. Republican Congresswoman Marsha Blackburn (TN-07) thought she’d take the temperature of her constituents regarding the Affordable Care Act and it didn’t quite go as Blackburn planned. Turns out, people like having health insurance. I was nodding along and enjoying the story until I reached the last paragraph, which reads:

It’s going to be up to us [Democrats] to stop them [Republicans] and defend the Affordable Care Act.

At this point I cringed. “Those are not the right words”, I thought. “They are very close, but they are not quite close enough”. Here is what those words should say, IMHO:

It’s going to be up to us [Democrats] to stop them [Republicans] and defend the primary goal of the Affordable Care Act: to ensure that affordable health CARE is available to all who need it in this country.

Both Democrats and Republicans appear to be involved in a partisan struggle for base political reasons, instead of working on behalf of ordinary working people. The ACA is neither ALL BAD, as Republicans shout, nor ALL GOOD, as Democrats seem to shout back. Neither answer is acceptable to common folks who are increasingly terrified by what seems to be happening to America’s healthcare system. Neither answer is acceptable to the majority of us in the 99%.

Democrats need to act like the adults in the room, and acknowledge that the ACA was a fabulous first step, but significant additional reforms are still needed . This shouldn’t be so hard to acknowledge, should it? Weren’t these the very same words that most of us were saying to each other back in 2009, when the ACA was passed? “Additional reforms are still needed,” we said. Remember? “The only thing wrong with the ACA is that it doesn’t go far enough.” Am I crazy? Isn’t this what we were all saying not so very long ago?

The ACA was a historic accomplishment, a BFD, and allows millions of people to have access to health INSURANCE. Awesome! Fantastic! Go Democrats! However, the ACA in its current state is also a deeply flawed law that simply does not have effective cost control measures . Many here may not like hearing these words, but please don’t kill the messenger. One of Clinton’s problems in 2016 was her message about the ACA: she embraced it as a fabulous program that only required a few additional tweaks here and there. This stance was a serious mistake.

If Democrats are intent on ignoring that truth about the ACA we should not be surprised at backlash aimed directly at it, and also increasingly on the Democratic Party itself for choosing to ignore an important pocketbook issue. The bottom line is that the Affordable Care Act is resulting in a system where health insurance is increasingly only “affordable” to the poorest persons in the country, the ones who receive assistance of one kind or another from Uncle Sam in order to pay for it. If that wasn’t bad enough, the Affordable Care Act is also turning out to be an enormous corporate welfare program. Insurance companies actually MAKE MORE $$$ under the ACA when the cost of health care increases, so they do little to reign in those costs. *** The cost of insurance is increasingly unaffordable for middle class persons who desperately want to buy it. *** When was the last time that you saw a Democratic leader acknowledge this truth? They would rather be cheerleaders for the ACA than acknowledge that great numbers of middle class persons are feeling squeezed and are deeply unhappy with the ACA. Poor persons have access to insurance, great!, but only because Uncle Sam is paying the outrageous rates that insurance companies are charging, WTF?

If only there was a way to bring down the high cost of health insurance itself. Fewer middle class persons would be priced out, that would be nice. We the taxpayers would save $$$ too. Did you know Medicare provides health insurance to Seniors, with an overhead rate of about 3%? Did you know that the ACA “limits” (hah, hah, hah, but that’s another diary) the overhead rate of private insurance companies to 20%? Why is their overhead rate so much higher than Medicare’s rate? Wouldn’t it be cool if Medicare could provide health insurance to folks other than Seniors? Seems like we might be able to spend 20% - 3% = 17% less on health insurance than we do today, almost immediately. Am I the only one who likes the sound of that? Maybe we could call this new government service Medicare-for-All, or perhaps the Public Option.