Any serious resolution to the healthcare issue MUST begin with an effort to reduce real medical costs, the ACA or GOP replacements don't really address. A reduction in medical costs means lower patient and insurance claims, meaning insurance premiums will be reduced. How much depends on the medical cost reduction. But healthcare improvements need to start here. Real medical cost can be reduced by a lot through sensible legislation and my favorite is major Tort Reform. If we could reduce the cost of malpractice insurance for doctors from $200,000/yr to $25,000/yr (hypothetical) and liability insurance costs for all other medical providers reduced by a similar percentage, the costs for all actual healthcare would be reduced significantly. Not to mention the need for defensive medicine and all the high cost associated with that eliminated. Once we see how much insurance premiums come down, we can look at insurance improvements like nationwide marketing and others.