Tens of millions of people with insurance should suffer so that a few thousand can get coverage? That's not a rational or fair exchange. I have a simple solution that doesn't require a giant convoluted law: if you can't get coverage due to a pre-existing condition and you can show that you couldn't afford insurance before that (as opposed to just not having it by choice), you automatically qualify for Medicaid. Done. End of story. It doesn't require navigators or exchanges or make insurance companies raise premiums on everyone else.

As I said above, the ACA fails to address the core problem with the health care system, which is not that some people can't get access due to pre-existing conditions. The core problem is the cost, and the cost component is tied to the inability of insurance companies to get together to dictate to hospitals how much they will pay (that violates antitrust laws), or the ability of hospitals to dictate how much they will pay for drugs, equipment, etc., or to turn away people who can't pay and have no insurance (particularly illegals). It may help individuals bargain against the insurance companies, but without the other components the insurance companies aren't going to lower rates. Until and unless that problem is addressed, tens of millions of people are going to be pissed as Hell next year and the Republicans will sweep both houses. I will laugh and laugh and laugh.