With the mandated health exchanges, either set up by states or imposed by the federal government, the Patient Protection and Affordable Care Act paves the way for states to adopt single payer systems. It's happening now in Vermont, and with Gov. Cuomo in New York signing an executive order to implement it, New York will likely be the first large state to implement single payer health care in the US.
It's a huge reason why the GOP was fighting it.
Red: They took a massive political hit to be sure, but already won a concession for the next large scale attempt to fracture the country, Immigration.
When you have 45 percent of the population locked up before you start a campaign, the political hit they took is meagre at best. Abortion, (no)Gun Control, Climate Change and Immigration are still out there to pander to for the base.
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