The recent court decision in Texas that invalidates the entire ACA (a decision that will be subject, no doubt, to numerous appeals and a future SCOTUS decision) exposes the fatal flaw at the heart of the ACA. That is is that the ACA in effect requires that universal medical care be funded mainly by employers. But, is that fair or reasonable to do?
The ACA relies on the largely ad hoc mechanisms for provision of healthcare that have sprung up in the USA over the last few decades as a result of our lack of political will and ability to address the issue in a comprehensive fashion. And, when you think about it, what we have is not a workable or fair approach. Our sky high healthcare costs and byzantine insurance and medical system are the result of all this. — Which is why employer based healthcare insurance is an approach not used in most other countries; and why government funded universal healthcare is the norm – and very successful.
While the Texas decision breaks the partial and beneficial mechanisms that ACA provided. But, it was never a complete or totally viable solution; nor was it ever envisioned as such. Ultimately, we cannot rely on employer-based insurance to fix all of the problems in our healthcare system; and Congress knew that when the ACA was passed.