Here’s the good news. We are probably as close to universal health insurance as we are ever likely to be. Only a tiny percent of the uninsured who are lawful U.S. residents lack access to subsidized health insurance. Here’s the bad news. Families at the bottom of the income ladder find that as their income goes up and down and as their job opportunities ebb and flow, they bounce back and forth among eligibility for Medicaid, eligibility for subsidized insurance in the Obamacare exchanges, eligibility for employer-provided coverage and sometimes eligible for none of the above. Consider these headlines:

• Infant Mortality Rises for the First Time in 20 Years
• For Those Without College Degrees, Life Expectancy Reached Its Peak Around 2010 and Has Been Falling Ever Since
• Almost Four in Ten Medicaid Enrollees Delay Care Because of Cost
• Traffic to Emergency Rooms Is Higher Than Ever. The Average Wait Time Is 2½ Hours
• Patients Wait 13 Hours for Free Health Care

What’s a better answer? Take money already in the system and give everyone a risk-adjusted tax credit to buy long-lasting private coverage in a competitive market. We are already doing that with seniors in Medicare Advantage. Why can’t we do the same for people who are being ill-served by the current system? How to fix our tattered Healthcare system. More From Forbes: