Any healthcare reform requires that consumers have sufficient affordable options to induce them to participate voluntarily. There are many paths to that goal, but none of them will be reached so long as crossing the political aisle means committing political suicide.
Upon passage of the Patient Protection and Affordable Care Act in 2010, conventional wisdom suggested the law would extend medical coverage to many Americans without it, while failing to curb costs.
Seven years later, that prognosis appears to have been largely on target.
According to the Centers for Disease Control, the percentage of Americans without healthcare insurance fell from 16 percent in 2010, to just 8.9 percent in the first half of 2016. On the other hand, many Americans were unable to retain the plans and doctors they had, and many have faced sharply higher premiums and deductibles.
And in some states and counties, insurers have withdrawn from participation in public insurance options, leaving some consumers with but a single choice.
In the wake of a Republican electoral victory last November, conventional wisdom suggested the GOP would move quickly to reform or entirely repeal Obamacare. But Republicans have struggled to do so, in part because parts of the law are popular, and in part because GOP senators remain deeply divided on what reform should look like.
But unless Americans are ready for a single-payer system, which I doubt, some kind of Obamacare reform is a near certainty.