this post was submitted on 23 Mar 2025
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The ACA was the best that could be done at the time, but it is a steaming turd and needs to be replaced with Universal Healthcare.
It is universal. I guarantee you Obama would agree 100% with a European style single payer system, which is what I think you mean.
It is not universal. There is a coverage gap just below the poverty line, between losing eligibility for Medicaid, and becoming eligible for ACA premium subsidies. Just a complete lack of coverage for the people with the greatest need.
(Edit: to be fair, that gap was supposed to be filled by Medicaid expansion, but that largely fell through)
The fundamental reliance on private insurers is the biggest gap in universality. Public healthcare is subject to the private sector's willingness to permit treatment. With some companies boasting >30% denial rates, that "gap" is a gaping chasm.
Good old "welfare cliff". It works this way with a lot of low income benefits.