I agree. There is no reason we can't pursue both simultaneously. Nothing in the ACA prevents posting of price lists or incentivizing patients with cash payout

I agree. There is no reason we can't pursue both simultaneously. Nothing in the ACA prevents posting of price lists or incentivizing patients with cash payouts for finding cheaper than average care. That is what has driven me crazy about politics -- it is more about making noise about the other side than actually doing something that might push things forward. Republicans could have pushed open market reforms the moment ACA was passed. If they did it on a state by state level they could even point to data of success vs pure ACA states to bolster their agenda.