Yes, in a heartbeat I would trade it for some massive transformation of society and institutions such that all allegations of sexual assault and abuse were handled with seriousness and decency, and all assaulters and abusers faced serious legal and social consequences.
But that just sounds like fantasy territory.
Like a couple of other posters, the ACA has been of such enormous benefit to my family that I do not see trading it for anything else.
For me personally, it has been of enormous benefit as it kept my daughter on my insurance and covered her for a bone tumor that otherwise would have bankrupted us.
We didn’t need to give up anything for the ACA. We simply failed to respond to the torrent of lies about it from before it was even passed. Death panels, “taking over the health industry” were two of the most common lies that the Democrats failed to address. Democrats either thought the Palinesque lies were too silly to be taken seriously or they became afraid of the hysteria rather than nipping it in the bud like they should have. Now all of a sudden the country has woken up to the realization that covering pre-existing conditions is a big deal and either affects them or someone they know. Why they couldn’t figure this out 10 years ago is beyond me.
Sure, if all that happened, then passing universal healthcare would be a snap. The ACA would not have had to have been watered down with republican input, based on a republican plan to, be bipartisan on a bill that every republican refused to vote for.
If things had come to pass as you say, then just waiting a few years for democrats to take complete control of the government would have made it so that there was no need of accepting republican ideas that held back the ACA from leading to universal healthcare. Sure, there would have been many hundreds of thousand suffering and dying while waiting those few years, but in the final analysis, with clearing the way to prevent republicans from obstructing people’s access to healthcare, the sacrifice that is demanded of them may be “worth it”.
Though, if I had a time machine, and the ability to get Obama to believe me, I wouldn’t tell him to scrap the ACA, I would have told him to push for public option and universal healthcare, and not to allow the republicans at the table, as they refuse to negotiate in good faith.
Let’s compare with “Hillarycare” as its detractors called it, which didn’t even get as far as a vote in 1994. That didn’t save the Dems then.
So while my answer to your hypothetical is that I’d have to think about it a bit, I’m probably not going to bother. In the real world, the ACA was worth it.
Other than the SCOTUS seats, which is a reach as far as being considered a “trade off” goes, none of those are reasonable things to sacrifice for universal health coverage. Yes, ACA didn’t get you the full way there but it has set a new line in the sand and has made ratcheting towards universal coverage plausible.
It was great for the insurance companies, great for those with pre-existing conditions that couldn’t get insurance, but really bad for insurance premiums.
Yes, two main reasons
[ul]
[li]Elimination of underwriting (the ability to deny/cancel coverage based on health)[/li][li]Decrease of uninsured from 22.3% to 12.5% (even lower if Medicaid expansion were complete)[/li][/ul]
Cost controls and a mandate with consequences would have been nice but now left for a later day.
A lot of you are arguing that the ACA is good, but I don’t think that’s the core of what the OP is asking. To put a tangible element to this, was it worth the unbalancing of the USSC? Because, frankly, that’s what’s happened, and if another shaky justice resigns or dies before Trump is out it’s going to have the potential to be even further unbalanced. And we aren’t talking about for an election cycle…we are talking, potentially for freaking decades. Are you folks who are saying the ACA is worth it REALLY saying it’s worth just that one aspect of what’s transpired? Further, was it worth us having Trump as president? 
I just don’t see the cost to benefit you guys are seeing for something that was a compromise that didn’t really do much and has been systematically attacked with attempts to gut it or roll it back.
I don’t accept that without the ACA we wouldn’t have gotten Trump. By the time Trump came along, the ACA was finally becoming popular. And further, I think the racist backlash was going to come inevitably, no matter the policy decisions Obama made.
You don’t think that it had anything to do with the mid-term elections during Obama’s presidency that saw a dramatic shift upward in Republican control of the house and senate that affected things when Obama tried to get a nomination through? You think it had no impact at all on a very narrow victory that Trump had against Clinton?? Well, I guess if you think that then it makes sense. I disagree, as I know a lot of my Republican friends and family were VERY riled about the ACA and it was a main talking point for them all through Obama’s term as well as the run up to the Trump election.
I think it had very little to do with it. I think Obama and the Democrats were going to try some sort of ambitious legislation, as they should have, and whatever it was would have been used against them. And if they did nothing, that would have been used against them too. They actually campaigned and won with health care as a huge part of their campaign. I believe most of the anger about the ACA was actually anger about Obama (i.e. culture and race), displaced feelings by people largely unaware of their own bigotries. And the ones who genuinely disliked the ACA due to conservative political feelings would have voted against Obama no matter what, since that’s what he campaigned on.
Maybe, but in the 2018 election it seems that Democrats used healthcare to flip a lot of Republican seats in Congress. And we saw that the Republicans couldn’t come up with any alternatives that weren’t political suicide.
ACA is rapidly becoming like Medicare - starting as socialized medicine, now loved by most.
As for the OP’s question, I don’t see anything swapping. Immigration reform would have an even bigger backlash, and had the downside of not benefiting voters.
Had your friends and family not been enraged about the ACA they would’ve been enraged about something else instead.
Part of the democratic losses on 2010 was that democrat voters were demoralized after seeing how gullible and inept the democrats were at governance.
Perhaps there would be a republican president in 2016 without the ACA, but what if it were Jeb Bush instead. Is no Trump but instead Jeb Bush worth sacrificing the ACA for?
The gist of this exercise is like a big hypthetical A/B test.
I was thinking of the benefits to the society, as a whole. If I’m purely selfish, I’d trade it for a stick of gum. My rates have skyrocketed since the ACA kicked in. It was pretty much an established fact that would be the case for folks like me-- self employed, not eligible for subsides.
But, as a self employed individual, do you remember trying to buy insurance before the marketplace?
When the ACA came into being, without a subsidy, it still saved me about a hundred a month, and it was better insurance than I had. Just being able to actual comparison shop in one place, rather than having to go through brokers who would not hold to a quote if you indicated that you wanted to shop around is immensely better.
It certainly has gone up since then, of that I cannot argue. But it was going up rather quickly before the ACA, and I don’t really see that it is actually going up faster than it was pre-ACA.
If it could be shown that your rates would actually be higher than they are now, as well as not covering pre-existing conditions, having lifetime limits, and all the other benefits we get from the ACA’s regulation of insurance products, would you still be so cavalier to dismiss it?
ETA: ACA’s done nothing for me. I’ve paid many thousands of dollars into it since it was created, and visited an Urgent Care about debris in my eye, once. I still support it.
Yeah, a lot of people forget how much the American left hated Obama and the establishment Democrats in 2010 for “throwing away” the promised hope and change. On this very board by 2012 we had people who had happily voted for Obama’s first term now telling people to vote for Jill Stein instead. So much disillusionment that only started to disappear around the time the Tea Party conservatives started showing up in force around 2014 that we began to see people rally around Obama again.
I guess it depends on what, exactly, the Dems had spent the political capital on. I don’t think, at that time, that immigration reform was the hot button issue it is today, but maybe I’m wrong about that. Not sure about the cost to benefit of Obama et al throwing their full fledged weight on, oh, say stimulus and pumping that up to higher levels. I do know that the ACA really pissed off a lot of conservative types in my own circle, but other things did to…the Syrian red line debacle comes to mind, as well as all that silly Benghazi stuff. Hell, a lot of liberal and left wing types were pissed off about the ACA, for that matter, though obviously for different reasons. ACA, also, impacted and riled up some of my more moderate/independent friends/family in ways I don’t THINK equated with those other things. Yeah, conservative/Republican voters would have voted the same as they did, but that wasn’t the difference…it was the blue dog Dems, independents and unaligned voters and disenchanted Bernie Bro’s that made the hairs breadth difference in the Trump vs Clinton election. She lost by a pretty thin margin. At a minimum, we are talking about the effect of that being 2 justices at least and was a complete change to the earlier make up and dynamic of the court.
I am struggling to see how what the ACA has accomplished is worth the price, though I guess if you think all of this was destined to happen regardless then no point in participating in this thread, since that’s what the OP is asking.
Disclaimer: I work in advertising, and have had several different health insurance clients over the past decade, and have specifically worked on advertising for ACA policies in recent years.
I think that, on the macro scale, the ACA did a lot more good than harm, as it opened up the possibility of getting health insurance to millions of people who simply couldn’t buy it, at all, previously… That said: for many people who were, in fact, able to buy “individual” policies in the pre-ACA days, the ACA wound up not being a good deal, particularly as far as what they pay for their monthly premiums.
Because the insurance companies weren’t required to cover everyone, and because they could sell policies that weren’t as comprehensive (i.e., policies didn’t necessarily need to cover screenings, preventative care, immunizations, contraception, had low lifetime maximums, etc.), the rates, while expensive while compared to getting insurance from your employer, were still considerably lower than they wound up being once the ACA came into force.
So, particularly for people who were buying what were fairly affordable individual insurance policies (especially what we used to call “catastrophic” policies, which typically only covered hospitalization expenses) before the ACA, they (justifiably) feel worse off now, because they’re paying considerably more. In many cases, they’re getting what are arguably better insurance policies, but they’re paying for them, and weren’t given a choice (other than to not buy a policy at all).