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Nah, we still would have had 9/11, which is unrelated to healthcare and was the catalyst for making the endless fear mongering being ramped up to overdrive.
Get everyone primed up on hating "Middle Easterners" genericly, normalize more.and more surveilence and errosion of rigbts in the name of protecrion, start strapping in other groups to hate as people lose interest.
Probably. I mean, I'm super interested in alternate history as a storytelling concept, but I recognize that it's probably not a super helpful thing to get caught up in unless you're actively looking for fiction. The Butterfly Effect is just too strong to be certain about anything.
Would 9/11 have actually happened? Or is there someone who died in 1999 due to lack of healthcare access who might've been able to stop it, had the ACA come a decade earlier? If 9/11 is a "canon event" a la Spider-verse, would having a few years where the political "heat" was a bit lower first have helped us maintain that solidarity that was so brief in our actual version of history? Would history have proceeded more or less as it did in reality, but with Republicans abandoning their attempts to kill health care in the late-00s because by that point it was too established and "from the before times?" Would they have replaced those legislative attacks with something worse? (Almost certainly yes)
I'm intrigued by the possibilities. To some extent because we can learn for the future by thinking about the past; but mostly just in a "huh, that's interesting" way.