......we're talking about real people and real lives. 

Now that Trump, Ryan, and their GOP brethren have failed spectacularly at trying to repeal and replace the ACA, it's time for members of congress who can reach across the aisle, governors, and health economics experts to come together, get real about the issues with the ACA in terms of reigning in costs for policy holders. 

I point you to these two articles I can across today. The first, a Politico article that's primary focus was on Rep. Mark Meadows, the leader of the Freedom Caucus that shot down the Trump/Ryan plan, but told the story of a rural North Carolinian's experiance with the cost of health insurance post ACA 

.....In North Carolina, the ACA has drawn significant enrollment — but it has clear challenges. In most of the state, only one insurer is participating on the Obamacare exchanges. The state elected a Democratic governor Roy Cooper last fall who wants to address the problems, and to finally get the state to take up the law’s Medicaid expansion option. But he faces a conservative, often hostile, state legislature. 

......Like many in the (Rep. Meadow's) district, Moore was suspicious of Obamacare from the start. He spurned the Obamacare markets in their early years, taking advantage of the law’s “grandfathering” option to stick with his original pre-ACA health plan. After two years of rising premiums, he jumped ship and joined Medi-Share — a Christian network that pools funds to help members cover each others’ medical costs. The $10,000-deductible plan covers his family of six for just $300 a month, he says, though it provides only basic benefits.

But after discovering a bulging disk in his neck, Moore got a little nervous. He bought an Obamacare policy for himself, which costs more than double his family’s Medi-Share plan. By his calculations, he could spend 24 percent of his yearly income covering the plans’ combined premiums and deductibles before any benefits kick in. He makes too much to qualify for subsidies under the Affordable Care Act.

“Our health care is so good, we can’t even afford it,” Moore quipped, cringing at the thought of cutting those checks each month. “God only asked for 10 percent.”.

The way he sees it, the entire health care system is broken. And fixing it starts with tearing the existing structure down — all of it. In his view, the failed House Republican health care proposal was nothing but a Frankensteinian version of Obamacare, rearranging bits of the existing law, fusing it with industry giveaways and bringing it no closer to the free-market ideal conservatives hoped for when Republicans swept into power.

“I was glad it failed,” said Moore, who voted for Trump in hopes he would revolutionize Washington, but is now discouraged by his divisiveness. “Why try to fix a broken system with broken parts?”

The other article was a https://www.google.com/">NYT piece about the problems small businesses have had with the ACA from a cost perspective. It's an important article I recommend you read it. 

.......As a bloc, small-business owners have been among the health care law’s most vocal opponents. The most powerful trade group for small businesses, the National Federation of Independent Business, is a fierce critic of the law and challenged its constitutionality before the Supreme Court. Some 60 percent of small-business owners want the law repealed, according to two recent surveys by Manta and BizBuySell, which regularly poll owners about their political and economic views.

But every business is uniquely affected by the complex law, and simply demolishing it without putting new guardrails in place is not, for most, the ideal outcome. Small-business owners overwhelmingly say they want Republican and Democratic leaders to quit their partisan bickering, acknowledge that the country’s health care economics are fundamentally broken, and work together on fixing the problem.

“The cost of health care had a significant impact on our profitability last year,” said Tom McManus, 46, the chief executive of KegWorks, a bar supplies retailer in Buffalo. “Obamacare made it worse, but I didn’t see anything in the new bill that would have made it any better. They need to focus on the real health care problem: cost.”

For Thomas E. Secor, who runs the small manufacturing business Durable Corporation in Norwalk, Ohio, every annual renewal of his company’s health insurance plan since the Affordable Care Act took effect has felt like spinning a roulette wheel.

Durable Corporation’s plan, which Mr. Secor said had worked well for the company’s 37 employees, omits some benefits that are required to meet the health law’s minimum coverage standards. So far, the plan has been grandfathered in, allowing Durable to keep it — but if that protection ends, Mr. Secor does not know if his company can afford to continue offering insurance, he said.

“Rural areas like ours are seeing insurance companies just flee,” Mr. Secor, 59, said. “Until somebody comes up with something that addresses cost, you’re going to see a continual erosion of coverage. I don’t care which party it is. Let’s all get together and work on a better product because what we have now isn’t working.”

Bipartisan cooperation on anything has become vanishingly rare in Washington, but one recent effort offered a glimmer of hope: In December, the parties aligned to overwhelmingly support the 21st Century Cures Act. The law increased funding for disease research and included an array of other health care adjustments and changes.

One of them was a fix long sought by small-business owners to an obscure — but, for some, devastating — Affordable Care Act clause that prohibited companies from using pretax money to reimburse employees for insurance that they bought on their own. The Cures Act revived that arrangement, giving it a legal green light for companies with fewer than 50 employees.

The change came as a huge relief for Warren Hudak, 53, who immediately took advantage of it to provide the eight full-time employees at his accounting firm in Lemoyne, Pa., with a monthly allowance toward their health care costs. He would like to see a similar across-party-lines effort to curb health care costs.

“I can’t believe anybody today would look at the Affordable Care Act and say, ‘It’s working fine,’” Mr. Hudak said.

He now pays $2,400 a month — enough, he said with frustration, to hire another worker for his business — for a family insurance policy with a glaring omission: It does not cover the $6,000-a-month prescription drugs his wife needs to combat her multiple sclerosis. Mr. Hudak said he had to contact the drug manufacturer himself and negotiate a discounted rate that his family could afford to pay.

“We have an insurance policy that would cover maternity and substance abuse treatment for my 11-year-old daughter but doesn’t cover my wife’s M.S. drugs,” Mr. Hudak said. “That’s insane.”

We heard as early as last Thursday night President Trump giving a take it or leave it ultimatum to the congress that it was either the AHCA or he was going to forget about health care. We heard a lot of backslapping from Democrats in congress over the weekend. 

But at the end of the day, we can't say what we have in place right now is good enough. I hope there is a continuation of work to fix the cost problems with the ACA so that it can remain sustainable for the long term.