Josh Blackman recaps at National Review Online key ideas some liberals are pursuing to address the Affordable Care Act’s failures.

The Affordable Care Act was never designed to be a permanent solution. Obamacare’s architects predicted that the law’s success would prove the government could be trusted to federalize health care, paving the way for a single-payer system. Reality has not been kind to their best-laid plans: Faced with failing exchanges and fleeing insurers, President Obama has urged Congress to “revisit a public plan to compete alongside private insurers.” Make no mistake: This is not a “tweak” or “reform,” but a grudging admission that Obamacare has unraveled way ahead of schedule.

During the early debates over the president’s signature legislative achievement in 2009, a schism formed among Democrats. The House’s bill would have allowed the federal government to sell a Medicare-like policy on the newly created exchanges. Although Senate majority leader Harry Reid supported the House’s so-called public option, Senator Joe Lieberman of Connecticut steadfastly opposed it. “To put this government-created insurance company on top of everything else,” Lieberman said, “is just asking for trouble.” Needing all 60 members of his caucus to clear the filibuster threshold, Reid ultimately eliminated the House’s provision from the Senate bill.

But that defeat did not foreclose the Left’s dreams of a public option. Instead, those dreams were tabled as the Plan B. MIT Professor and Obamacare mastermind Jonathan Gruber predicted that whether the law succeeded or failed, the end result would be the same. On one hand, Gruber argued that a successful implementation of the ACA would build confidence and support for nationalized health care, assuring liberals that “if you like single payer, then Obamacare has to succeed.” On the other hand, he warned that the ACA was “the last, best hope for private insurance,” and that if it didn’t work, we would “have to rip it up” and “revisit some kind of single-payer system.” Heads I win, tails you lose. (Indeed, through Wikileaks we’ve recently learned of Hillary Clinton’s active supports for a revision that “begins the unraveling of the ACA.”)

Unsurprisingly, after only three years, Obamacare is currently spiraling down the latter pathway.