In fortifying for-profit health care companies, the Affordable Care Act became a cautionary tale about the political supremacy of an insurance industry that many Americans hate. But it has now become something even more profound: the ACA’s modest popularity, forged in desperation, proves that an initiative can now be considered a political “win” even as it preserves a problem, steamrolls alternatives, and makes a crisis more difficult to fix.

In essence, a policy sold on the “audacity of hope” has helped deflate hope for anything better.

This past weekend, winning and hope were the big messages from the White House, where President Joe Biden and former president Barack Obama released a video celebrating the news that a record thirty-one million Americans are now getting their health insurance coverage through Affordable Care Act exchanges and an expanded Medicaid.