Why the Democrats will lose the shutdown battle

I will quote you on this, "Can you stay on topic?' This has nothing to do with Canada.

.that's what the Obamacare subsidies do.

Coverage and available insurance companies are limited under obamacare

Yeah, that's been talked about for decades, never happens.

If the democrats are serious about addressing the situation then it can be done

Republicans (as proved by our posters here) like to blame the ACA for expensive insurance.   Obamacare did almost nothing to address our private insurance market costs which have always outpaced national inflation.

The one thing it did do to lower insurance cost was the individual mandate which people like Tom hated.    They couldnt stand the idea that the evil government was forcing them to buy something they didnt want.   So Trump got rid of it in his first term.    

The only alternative solution to private insurance is Medicare for all - something the liberal wing of the Democratic party has been pushing for since 2008.       Republicans really hate that idea and anyone who mentions it will reflexively be met with a response of phrases like "Venezeula" or "Communism".       Nevermind Medicare has no shareholders to answer to and has an approval rating light years beyond any private insurer.

You just described exactly how Medicare works.    Now ask Tom if he supports Medicare for all in the US.

Spoiler alert:  His posting history on that exact question is a resounding no.

You would have to change this:

"Insurance is regulated by the states. This system of regulation stems from the McCarran-Ferguson Act of 1945, which describes state regulation and taxation of the industry as being in “the public interest” and clearly gives it preeminence over federal law."

When has any party, Republicans, Democrats, or MAGA addressed this?

What state regulations prevent an insurance company from doing business there?  I dont get it.

Insurance companies have networks of doctors in every area they serve.    I've long heard people say "opening the state borders" would allow insurance companies in other states to compete.    Really?   How would an insurance company in Montana with a network of doctors in Montana be of any use to someone who lives in New Jersey?    If that same insurance company wants to set up a network of doctors in New Jersey they can.   No Federal or state law Im aware of stops them from doing so.  Am I wrong?

Tom said, "Remember when the Obama gang said insurance premiums would go down"

Tom, remember when I called that out years ago in the old forum? I knew adopting the heritage foundation plan as first implemented by Mitt Romney was a mistake. I also said the subsidies would have to be regularly increased because medical inflation runs much higher than wage growth. 

That being said Trump has no understanding of how health insurance and healthcare works in the US. He operates on the assumption that private insurance companies will insure anyone that wants to buy a policy and that those polices they sell would be affordable for people to buy on their current wages which isn't the case.

Don't forget about all the small and medium sized companies that use the ACA exchange to provide coverage to their employees. Trump's plan would leave those companies with no way to cover their employees for 2026.

It is a shame. I think Trump could actually get something done on healthcare but his small mind doesn't grasp if he wants to save the government money as well as the citizens you would have to go to a single payer system like the rest of the world.

But my how times have changed.  I see Tom and David advocating for the elimination of private health insurance companies.

Every state regulates insurance companies by its state laws, so if there were a national framework for every insurance company to operate in, then they could tailor their coverage for the entire country instead of each state. You need to understand the "law of large numbers". 

If I'm a small business with 10 employees who are 50 years old or more, and I want to provide health insurance to my employees, it's going to be hugely expensive. If I'm a company of 10,000 employees from 18 years old to 81 years old, much less expensive per person.

If I can spread the risk over 50 states and include everyone in all the states under one set of rules, theoretically, it would be cheaper. It has nothing to do with in-network doctors.

That's why Obamacare had the tax penalty for not having health insurance; it was to spread the risk over a large number of people. Trump eliminated the penalty, and now MAGA whines that Obamacare hasn't lowered health insurance premiums, because they don't understand adverse risk.

By the way, "adverse risk" in insurance terminology means the people who need insurance the most will buy it at almost any cost, and the less that someone may need it they will put a much lower value on the price they will pay. For insurance to work, they need a large sampling of everyone's demographic to buy a policy.

I guess that makes sense.   It also explains why homeowners insurance is more expensive in coastal states than the Midwest.    Same logic.    Im not sure I'd want to change that, though.

I think the biggest issue to competition is just population distribution.    THe insurance companies have a similar sales profile as an airline.  Big city airports have enough people for all the airlines to find passengers....so in Chicago you can choose between Delta, United, American and others to fly to NY.     If you live in Topeka, KS then you probably only have one airline.   Topeka didnt pass a law or regulation to limit competition.   Its just not financially worthwhile for all of airlines to fight over a small group of people.  Same for insurance companies.