On October 16th, the first domino fell. The first state government (the Commonwealth of Kentucky) communicated their decision to discontinue all payroll deductions of voluntary benefits, starting in 2019. In short, this is a watershed event in accelerating the death of traditional payroll deduction.

The new rules “could leave millions of women without access to birth control and reverse some of the important public health progress made under the Affordable Care Act in recent years."

Meanwhile, liberal and moderate Dems must decide whether to embrace a broad expansion of insurance as they prepare for the 2020 presidential elections.