>> It's been pretty sad thus far - the failed attempts at a Muslim ban, the insane Obama-care replacement deal, the rolling back of all the work Obama did with the environment, and the appointment of some of the most unqualified people in history to lead departments, etc etc etc.

I'm quite concerned re the ACA - and in fact have taken the foot off the pedal in the US for now. IMHO the ACA *definitely* was a step in the right direction towards better access and pricing, but today it's begun the insurance death spiral (worth googling that term.) Firstly: without a credible individual mandate, you simply can't have guaranteed acceptance and no pre-existing exclusions. That's not a criticism of the weak ACA IM, since Ryancare proposed to do away with the IM altogether.

The point is that unless there's a serious penalty for not participating, why would you take insurance until you get seriously sick? Wait until it happens, then pay a few thousand $ premium and consume $250K care. Which is what Anthem recently described before exiting the ACA altogether.

Stands to reason that if everybody in the scheme is sick and consuming more healthcare than their premiums cover, then premiums have to rise which further disincentivizes participation by well customers needed to make any insurance work, and before long you're worse off than the bad old affordability days. This is the death spiral and the ACA is in it. The nail in the coffin is ACA subsidies expiring, which will cause a massive explosion in cost unless the Republicans are willing to prop up the ACA. Finally, all it needs is for an insurer who is the last remaining ACA participant in a state, to signal it can't afford to stay... and the wheels fall off completely.

Was Ryancare better than ACA? Part of the issue is that if you want to critique Ryancare, you need to compare to the alternative. Otherwise you risk fiercely criticizing the fittings in a lifeboat... as the Titanic goes down. This was not done, partly because of the rushed Ryancare effort. But once the subsidies expire, there may well be just as many millions unable to afford the ACA.

IMHO doing away with individual mandate is a ridiculous idea and I can't understand why the Dems aren't all over it. Instead, it's all so partisan and disorganized that the ACA will be allowed to fail and the crisis replacement will be some rushed idiocy that costs the taxpayer (that is not not not the single payer!) a fortune and makes lots of $$$ for insurers, but collapses in turn as the long-suffering US public wishes they were 65 so they could "enjoy" Medicare whose $47T deficit seems benign by comparison.

IMHO Trump isn't unhappy with his political position: he gets to say "I tried" and if anybody calls him insane, he can tweet "I tried to replace this mess, you blocked me, you got exactly what you wished for- and still you blame me? Sad."