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The rest of the ad advocates for premium tax credits, a provision of the Affordable Care Act, that enables the federal government to partially subsidize the cost of private health insurance.

There are currently no caps on how much private specialists, dentists or hospitals can charge and neither private health insurance nor slim Medicare rebates reliably offer substantial relief.

A study by Harvard researchers found that fewer than 1% adolescents with private health insurance received either puberty blockers or hormone treatments.

In the course of doing this, Emanuel repeatedly attacked the idea of replacing private health insurance with a “Medicare for All” system, calling it a “pipe dream” and writing, “I’m mystified as to why, at a moment when 90 percent of Americans already have insurance, our presidential debates are focused so exclusively on expanding coverage rather than containing costs.”

Roughly one in five Americans covered by private health insurance reported their provider refused to pay for care recommended by a doctor last year, according to a survey by health policy foundation KFF.