Republicans are about to make Medicare-for-all much more likely

[Jim Lane]

23. I'm not assigning blame. I'm stating the FACTS about the situation under the ACA.

Under socialized medicine, as it exists in many other countries (albeit with some differences among them in terms of the specifics), there is no role or only a supplementary role for private insurance (procured by the individual or by the employer on behalf of the individual). Under the ACA, such private insurance remains the cornerstone of the system. Therefore the ACA is not socialized medicine.

It's also not universal insurance coverage, because, even without the Supreme Court ruling, not everyone would have had insurance.

Finally, it's not universal health care, because, with or without the Supreme Court ruling, not everyone with health insurance would thereby get health care.

It would be misleading to say that the ACA envisioned the "Medicaid gap" by which a few million people in Republican-controlled states would be too rich for Medicaid and too poor for ACA subsidies, and would therefore be out in the cold. Of course I did not say that.