By eliminating the donut hole, which research has shown is responsible, far more than anything else, for creating awareness of generic drugs, which is the most important cost reduction ANYONE has made to our health care system. And which is the reason it came in under budget year after year, in fact, every year of its existence until 2009.

Leaving it as it was would have been vastly better than ACA. Immeasurably better. We had the best health care system in the entire world. It was expensive, but the best usually is. If you wanted to add guaranteed issue you could have done that for a comparably small amount of money.