I say "trivial" in that it did not actually change the core elements of private insurance and employer sponsorship. It's a slightly improved version of the old

I say "trivial" in that it did not actually change the core elements of private insurance and employer sponsorship. It's a slightly improved version of the old system -- one which recently provoked literal blood lust from both sides of the aisle. Within that framework the changes can be seen as significant. But that framework is widely despised in the US and considered insane everywhere else.