In Virginia, Republicans have shown how principled opposition to Medicaid expansion can be popular and helpful to the state's finances.
In January a poll by the Wason Center for Public Policy at Christopher Newport University found that 38% of Virginians opposed the Medicaid expansion. By late April, 53% were against it.
Meanhwile, Medicare is being slowly changed by the semi-free market of Medicare Advantage plans.
Austin Frakt, writing in the NYT, says that Newt Gingrich's 1995 prediction that medicare would wither on the vine if people were allowed to choose subsidized private insurance is turning out to be correct. From the article.
No matter the reason, what’s clear is that Medicare Advantage is a strong and growing program, despite recent moderation in government subsidies. As Medicare Advantage grows, traditional Medicare necessarily shrinks and its influence on the American health care system weakens. If the trend continues, policies, including those in the Affordable Care Act, designed to use traditional Medicare as a tool to reshape health care delivery for all Americans may become less potent. Is there a tipping point at which traditional Medicare ceases to matter?
Meanwhile, the GOP is eventually going to have to provide some positive alternatives to the ACA. There are no shortage of good ideas, see my proposals here. Reason's Nick Gillespie steals some of these ideas (which I stole from John Mackey).