"We warned the president -- don't ever, ever agree with the Republicans,"

[Hoyt]

145. I doubt if most states have the ability to monitor and enforce it. Feds do. Plus --

Exchanges will put pressure on costs.

And if I'm not mistaken, insurers are already making refunds to patients/subscribers under federal MLR requirements. So, something is happening.

Private insurance companies -- Blue Cross, United, Cigna, etc. -- administer Medicare right now at the local level (under federal rules). If the "profit" is capped, I have no real issue with using that framework (again, under federal guidelines) to transition to where we need to be.

Again, I'm not saying ACA is better than single payer or public option. But, it's better than what we had before and can be modified much easier than starting from a big hole. It is so easy to add a public option to ACA. And, we can purchase insurance from not-for-profit health delivery systems.