The justification for the Rude Goldberg design of the Affordable Care Act was that state based exchanges would bring the incredibly “magical” power of competition to concentrated insurance markets. So far that it doesn’t seem to live up to its promise. When the law goes into effect next year highly concentrated markets, like Maine, will remain highly concentrated.

As the largest caucus of Democrats on Capitol Hill, the Progressive Caucus has heavyweight size but flyweight punch.

Even though raising the Medicare retirement age is both deeply unpopular with voters and a terrible policy that saves the federal government only a modest amount of money, it is still treated by the Washington media as an idea to be seriously considered. During what little TV news I’ve watched in the past week, I have seen multiple elected Democrats asked about it. If we are going to be discussing changing Medicare eligibility age to reduce the deficit what we should be talking about is lowering it.

The need to offer a substitute to placate those desiring a public option created this Frankenstein monster, which was admittedly not well thought-out. Those who did it ended up with the worst of all possible worlds; no public option supporter really even knew about these multi-state plans, and they have the potential to disrupt the exchanges and cause a race to the bottom.

As we are only nine days away from CAMPAIGN 2016 (kickoff event, the Christie Lapbandoning) the candidates for this election cycle are bringing out the promises. And this one had a nice ring to it.

Dear Reader: What caused the members of Official Washington’s institutions, particularly those part of or linked to the institutional Democratic Party, to go after Jane Hamsher hammer and tongs? Answer: Her insistence on pushing for at least a public option in the health care bill — and her warnings that without a public option, the bill would become a deadly stinky rotting albatross of a millstone around the Democrats’ collective necks in November of 2010. She was right, she was proved right, and now Steny Hoyer’s finally admitted it.

On the front of Politico is an article about how the big bipartisan deals that used to be relatively common in Congress now appear to be a thing of the past. Good bye and good riddance. At their core these bipartisan deals were and are about destroying basic democratic accountability.

As I wrote earlier, the public option fight changed the progressive movement. You had a popular, compromise measure that the public supported, where advocates did everything right, and none of it mattered. Now, the head of HCAN, the labor-backed coalition trying to pass the Affordable Care Act in 2010, confirms the public option was traded away in the midst of the fight.

The progressive movement is undergoing a transformation where they no longer see engagement with candidates as the best or only strategy to advance goals. Those not hopelessly alienated by the entire political process prefer outsider strategies that force political pressure from the bottom up, rather than relying on the promises of those politicians to carry the day. That’s the new reality, and the public option fight was such a catalyzing event, that I don’t see it changing anytime soon.

Mitt Romney’s Medicare “reform” proposal is a takeoff on Paul Ryan’s voucher flim flam, shifting costs to more seniors and raising average costs for everyone. He claims to provide more choice, but seniors can already choose between straight Medicare and private insurance Medicare Advantage.