There is a part of the Affordable Care Act that is not at all working as originally envisioned, because the Supreme Court dramatically altered the structure of the law when it ruled that the expansion of Medicaid should be voluntary for states.
There is nothing simple about the journey to make health care available to all. And there is certainly nothing simple about forgetting that behind every single statistic there is a beloved child of God deserving of healing and hope.
The Kochs' sabotage is shrewder than defunding Obamacare because it goes to the whole basis for the Affordable Care Act's plan to cover the uninsured: the creation of a risk pool that includes the young and healthy as well as the not young and not immortal.
I've often said that the Affordable Care Act is the end of the beginning of reform. Starting tomorrow, October 1, 2014, that law will signify the beginning of the end of the health insurance industry as we know it.