Ironically, as congressional Republicans have been trying to replace the Affordable Care Act, the ACA’s popularity is at an all-time high, and the majority of Americans now believe that it is the federal government’s responsibility to provide health care for all Americans. This shift in sentiment suggests that a single-payer system — a “Medicare for all” — may soon be a politically viable solution to America’s health care woes.

During the past 25 years, the life expectancy of the richest quintile of 50-year-old Americans has increased, a perhaps unsurprising development. However, this improvement has not been shared by all. The life expectancy of the middle 60 percent of Americans has seen little change, and the life expectancy of the poorest 20 percent of Americans has, during this time, actually decreased.

The United States spends more on health than any other economically comparable country, yet sees a consistently mediocre return on this investment. In my last piece, I argued that this is because the U.S. invests overwhelmingly in medicine and curative care, at the expense of the social, economic, and environmental determinants of health—factors like quality education and housing, air and water safety, and nutritious food. A deeper investment in contextual factors like these can help create healthy societies and prevent disease before it occurs.

Last month, the Congressional Budget Office released its evaluation of the House of Representative’s American Health Care Act. According to the Congressional Budget Office, the AHCA would, if it becomes law, leave 23 million more Americans uninsured by the end of the decade. While the Senate’s newly unveiled bill will receive similar scrutiny in the coming days, much has rightly been made of this figure and the consequences of so many losing vital coverage. Proponents have framed the legislation as a chance for Americans to take personal responsibility for their health, while opponents have decried its potential to sicken and kill many of our most vulnerable citizens. These concerns are valid. The bill stands to do great harm.

On December 12, 2015, in Paris, representatives from 196 countries agreed to tackle the growing threat of climate change. Together, they committed to keeping the global average temperature below 2 degrees Celsius through substantial reductions in greenhouse gas emissions. At the time, only two countries did not sign the accord — Nicaragua and Syria. On Thursday, President Trump added the United States to that list.

These are divided times. In Washington, a new administration has deepened the polarization of an already gridlocked political process. In the media, our disagreements are expressed, and often amplified, by a host of competing voices. The questions they address include: How should the Constitution be interpreted? Should we embrace free trade or focus on rebuilding our industrial base? What is the role of immigrants in our society? With so much to debate, issues that inspire true consensus are hard to come by. Yet there is one item on which everyone can agree: We all want to be as healthy as possible.

These are divided times. In Washington, a new administration has deepened the polarization of an already gridlocked political process. In the media, our disagreements are expressed, and often amplified, by a host of competing voices. The questions they address include: How should the Constitution be interpreted? Should we embrace free trade or focus on rebuilding our industrial base? What is the role of immigrants in our society? With so much to debate, issues that inspire true consensus are hard to come by. Yet there is one item on which everyone can agree: We all want to be as healthy as possible.

Last Thursday, congressional Republicans voted to pass the American Health Care Act, the first step in fulfilling their pledge to “repeal and replace” former President Obama's health care law, the Affordable Care Act. This comes after attempts to pass an earlier version of the Republican health care bill implodedabout a month ago. If the new version of the bill becomes law, it stands to reshape both the landscape of American health and the health care industry -- one-sixth of our economy.