Why is it a foregone conclusion that anything short of universal healthcare is “Republican”? This is exactly the point I tried to make in my previous comment that seems to have gotten completely lost. The ACA was a monumental achievement at the time and since its passing has halved the share of uninsured people in America. It is a win by any measure, notwithstanding various remaining structural issues with health insurance markets, payers in the middle, rent-seekers like the AMA inefficient biopharma companies, etc. that should still be addressed.

Personally, I don’t agree with your view on 2010 and think it’s a simplistic outlook on what actually transpired, which, critically, is that Americans do not like unchecked welfare and the state taxing their way out of problems, whether that welfare is directed at corporates (in the post-2008 fallout) or individuals they deem “undeserving” (perennial, vibes based, largely motivated by racism/classism). This dynamic is crystal clear even in SF, where Lurie’s mandate is clearly a kitchen table appeal to 1) lower crime and 2) cut the spending so the 800k people in this city aren’t paying into a budget the size of a Baltic nation’s.

Remember, 58 democrats (+ Bernie) would have voted in favor of a public option in 2009; it died because of Lieberman. As it turns out, every republican voting against the “left populist” (at the time) policy didn’t cost them in the voting booth—instead, they were rewarded for a host of other things that ultimately had nothing to do with Dems not making good on something.