If the ACA is repealed, with it will go the protection it offers individuals with preexisting health problems. They would again be denied health insurance or subjected to unaffordable insurance premiums.
The rapid transition from a non-conducting to a conductive state produces a brief emission of light and a sharp crack or snapping sound. A spark is created when the applied electric field exceeds the dielectric breakdown strength of the intervening medium.
The spark ionizes the air, which becomes conductive and allows an arc to form, which sustains ionization and hence conduction. A Jacob's ladder on top of the switch will cause the arc to rise and eventually extinguish. One might also find small Jacob's ladders mounted on top of ceramic insulators of high-voltage pylons. These are sometimes called horn gaps.