"As we now pivot to Chapter Two for the [ACA], the realities are these: [1] The healthcare system needs improvement. Affordability is the issue one.... [2] The [ACA] has flaws. It successfully increased coverage for 20 million who were uninsured via Medicaid expansion and subsidized coverage for individuals via the marketplaces, but at a hefty price -- $1.1 trillion over 10 years -- and the rules whereby insurers are required to structure and price their plans are problematic.... [3] The strength of our economies--locally and nationally -- is closely tied to the effectiveness of our health system."

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