The ACA isn't single-payer healthcare (and didn't really bring down the cost of healthcare much if at all[0]), so I think by the standards of the left in other countries, it is window dressing.

0: https://en.wikipedia.org/wiki/Affordable_Care_Act#Insurance_...

We're not talking about the left in other countries, we're talking about the left in the United States. Within that context, the ACA is a progressive piece of legislation. You can just agree to the point rather than move the goalposts.

The ACA was considered a Republican-friendly approach to health care prior to it becoming a partisan issue (More or less the same approach was introduced by Romney in Utah). It's not particularly progressive, either in comparison to other countries or past attempts in the U.S., and is only really considered such because it turned into a blue team vs. red team issue.

> The ACA was considered a Republican-friendly approach to health care prior to it becoming a partisan issue

That's...misleading. Sure, the broad outline of a policy like the ACA first emerged as a joint Republican/insurance industry idea for national reform after the failure of the Clinton healthcare plan when it looked like there might still be enough demand for some national reform that they could use a strategy, and yes something broadly similar was pushed successfully by Republican Governor Romney at the state level (in Massachusetts, not Utah.) But even the national Republican party had moved right since then, under Bush, they had toyed with mandatory purchase of specifically HDHP/HSA plans, rather than traditional insurance, before deciding that health reform wasn't something that even needed to be on the agenda at all.)

Something like the ACA as a state-run program had none of the Constitutional problems the ACA has as a federal program. Then again, pretty much every elected American politician only believes in federalism when it suits their agenda.

I think you may also find that what's considered a Republican-friendly compromise in Massachusetts in 2006 - where Romney was actually governor - may be different from where the party of Trump and McConnell find policy to be Republican friendly.

Sorry, I was wrong on the location. I don't think that opposition to the ACA began with Trump though (witness the resistance getting it through in the first place). Republicans opinion of it did a nearly complete 180 almost immediately after Obama started advocating for it - far too short a time for the Republican party ideology to change.

Is it too short a time for Massachusetts Republicans to make different compromises than the national party in federal legislation, though? Let's not pretend that a Republican in Massachusetts, California, Illinois, or New York is in the same situation as a Republican in Alabama. Nor is a Democrat in any mostly red state going to have as much leverage as in Massachusetts.

I was a vocal supporter of the ACA when it passed. Then I had to actually use it. It's garbage. I still couldn't afford health care, and then at the end of each year I got punished for it. The ACA is a failure.

Its only component that is even slightly progressive are the subsidies for some lower income people to get insured. From a conceptual and philosophical level, it is quite conservative and has its origins from moderate conservative state government administrations. The only reason people think they can call it progressive with a straight face is because the republican party, in their quest to oppose anything and everything that comes from the left, decided it was a bad idea the moment the democratic party used it as a compromise to get a few blue dog democrats on board.

Does the US even have a chance of people passing single payer? I imagine we'll see people lighting themselves on fire in front of Congress before that happens.

Glad you mentioned the Paris Agreement. How about we ratify the agreement so it becomes a treaty otherwise post 2024, it may go out the window again.

As far as window dressing goes, we see this from both parties. They talk and vote radical when they are out of power. When they are in power, everything is status quo.

Ratifying it requires 2/3 agreement in the Senate. That is impossible to achieve in the current political climate.

Dodd-Frank has been fairly successful, but the rest of those are emblematic of the window dressing approach.

The ACA is incredibly complex, widely variable in implementation, and didn't actually help healthcare costs. Repealing Don't Ask was a symbolic step. Actual change in LGBT rights came from the Supreme Court. The Paris Agreement is the ultimate window dressing; it allows every country involved to point to it and say they're taking action on climate change, without requiring literally any changes.

These are all classic Democratic Party moves. They take on the appearance of doing something while kicking the issue down the road a few years for someone else to deal with.