Megan McArdle published a great piece, “Modesty Could Have Averted the Anguish of Obamacare,” on Bloomberg yesterday. Parts of it read like a soliloquy over what could have been had the Obama administration pursued incremental changes to the healthcare market rather than sweeping transformation. The ACA has been less of a hot-button issue this election cycle than in the past three, but the ongoing deterioration of the exchanges promises it will visit us in the headlines for a long time to come. The ACA has insured millions of new people—so in that regard it has been successful—but with the mass exodus from employer plans not materializing and the exchanges absorbing a high percentage of previously uninsurable customers it looks to be devolving into little more than a Medicaid expansion that will continue to cost taxpayers thanks to subsidies. President Obama expended an extraordinary amount of political capital passing the law, and one wonders whether that effort—to say nothing of the market disruptions—will have been worth when all is said and done.