The no-pay, slow pay, and partial pay, uninsured who find out they need medical care after all, drive up the costs for everyone else. Address that problem, and then there's some serious leverage to bring down average costs.  Insurance companies in Alaska struggled to deal with the former uninsurables that were brought back into the system by the PPACA. The State of Alaska addressed that problem last year with legislation, and 2017 was to be the first full year with that fix in place. We also now have the Medicaid expansion in place. In many way, the signs point to things getting better from here on out. As long as the politicians don't screw up this painfully slow progress we've made with a half baked replacement.

Just fix what is broken with the PPACA and check the partisan pride at the door.