Even Rupert Murdoch’s Wall Street Journal can’t ignore the fact that the Affordable Care Act, for all its shortcomings, has been a tremendous success when it comes to getting more Americans the health care coverage they need. Last year, the numbered of uninsured dropped to 10.4%.  It’s the largest decline in in 28 years – and that number is still dropping. It’s had a tremendous impact in places like New Jersey, where in some counties, the number of uninsured dropped by 30% (which is something Chris Christie probably doesn’t want to acknowledge).

Much of the Affordable Care Act’s success is attributable to the subsidies and rules prohibiting insurers from discriminating based on pre-existing conditions and allowing children to stay on their parents’ policies until age 26. Another factor is the Medicaid expansion in those states that have chosen to participate.

The success of the ACA is unwelcome news to the GOP, which has tried for the past few years to get the law repealed. Significantly, though Republican presidential candidates have mentioned Obamacare in passing during the first two primary debates, it has not been a major topic of debate like immigration and income inequality. Like it or not, it’s the law of the land, and it’s working for the majority of Americans.

Unfortunately, too many Americans are still falling through the cracks. In 21 states that have chosen not to participate in the Medicaid expansion, there are at least 31 million Americans whose incomes are too high to qualify for Medicaid and too low to qualify for subsidies on state or federal exchanges. It goes without saying that they cannot afford the egregious premiums charged by profit-driven corporate insurers. Furthermore, these people are still slapped with tax penalties for not having insurance. That penalty goes up every year – and while it may be less expensive to pay that penalty today, it will not be in five years.

This points up the need for a simple, straight-forward, government-run, single-payer system. The ACA was – to use Thom Hartmann’s description – the proverbial “camel’s nose under the tent,” but until our legislators get it through their heads that as long as they have to pander to private insurance companies and for-profit health care providers, there will be people who will suffer and die from inability to access medical services as needed.

And don’t expect the GOP to come up with any ideas of its own. We know what the solution is and who is standing up for it.

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K.J. McElrath is a former history and social studies teacher who has long maintained a keen interest in legal and social issues.