because:

"When it comes to health insurance, market-oriented solutions are the most expensive option.

This is a reality centrist Democrats found themselves facing awkwardly when they sat down to write the Affordable Care Act in 2009

"Moderates" liked the idea of subsidizing the purchase of private insurance more than they liked the idea of expanding a government insurance program. But they also liked the idea of spending less money rather than more. And it turned out that on a per patient basis, expanding Medicaid was cheaper than extending subsidies to buy private insurance. Democrats had to choose between their ideological aversion to government insurance and their ideological aversion to higher spending, and ultimately wound up deciding that a hefty dose of Medicaid expansion was a better idea than pushing the spending total up.

But this is exactly the point that Republicans - who are much more averse to federal social spending than even the most centrist Democrat - consistently refuse to acknowledge.

Almost across the board, government solutions are cheaper:

-------------------------
"The truth is incontrovertible.
malice may attack it,
ignorance may deride it,
but in the end,
there it is." -Sir Winston Churchill