You do realize the reason the Democrats can’t fix it is that the Republicans block all attempts right? Like when 59 Democrat Senators, the President and a majority of the house (100% Democratic support) are attempting to pass something like Medicare for All as happened in 2009 — the fact that it was blocked because they couldn’t get a single Republican vote to break the filibuster reflects badly on the Republicans, not the Democrats.

The Franken recount and Kennedy death meant they couldn’t negotiate further and had to pass the reconciled bill for Obamacare without a Medicare buy-in option, unless they had literally any Republican cross the aisle - which they refused to do. It’s just such ignorant bad faith to claim otherwise.

And since primary taxation happens at the Federal level, the state-options are essentially impossible without the Feds giving states that provide universal healthcare the ability to not pay Medicare/Medicaid payroll taxes — again which is impossible without Republicans support.