[pcwalton]

The difference is that Medicaid is a patchwork of various state systems rather than a no-questions-asked federal subsidy. Some states are hostile to Medicaid (e.g. Kentucky with its work requirements). Furthermore, the entire future of the ACA system is in doubt, because of executive sabotage, legislative attempts at repeal, and judicial overreach. All of that leads to people not being confident that they will be able to get the health insurance they need. That's why the Swiss system can fairly be described as universal health care, while the American system cannot.

[tptacek]

What reform could the US pass that would escape the criticism that Republicans might in the future choose to repeal it?

[pcwalton]

I don't know. I'm not sold on single payer either, mind you. The only long-term solution I can really see is for the Republicans to fail at repealing the ACA so many times, and for public opinion to be sufficiently against them, that they basically give up.