The history of health care reform in America reflects a dynamic interaction between the two political parties, write James Morone and David Blumenthal, M.D., in the new issue of Health Affairs. Republicans oppose Democratic plans emphasizing public insurance, countering with plans that instead rely heavily on private markets. The next wave of Democratic proposals then absorbs some elements of the latest Republican proposal, and the cycle continues.But the authors say that the assault on the ACA suggests this pattern has been broken.