What it is: Alaska’s GOP-dominated legislature has passed and Sarah Palin endorsed Governor Bill Walker has signed a bill to bail out the state’s one remaining Obamacare insurer, using $55 million in tax money.

Take a look: http://www.politico.com/story/2016/06/alaska-obamacare-collapse-224149

What it is not: A sign that Republican states are just caving in to the inevitability of Obamacare.

Why it’s important: It is instead a canonical case of the real vulnerabilities of the Affordable Care Act. Especially after a Marco Rubio-sponsored bill managed to strip the ACA of federal funding for its “risk corridors,” which provided money to shore up insurance companies that guessed wrong on the risks of the populations they were taking on, insurance companies have found it very difficult to stay in business in the Obamacare exchanges.

Will it work? If the goal is to keep this one insurance company solvent and involved in insuring Alaskans, that’s hard to tell.

But it already works as a demonstration of something bigger. The real difference between the U.S. and other medical-advanced countries is not just that the U.S. does not insure everyone for healthcare, it’s that for lots of weird reasons, Americans don’t have a consensus that healthcare is and should be for everyone. A significant portion of Americans seem to be saying politically that it’s okay if some people just suffer and die for lack of access to healthcare, or are impoverished in the attempt to pay for it. Or at least that some vague “somebody else” should take care of the problem.

This Alaska legislation cuts right to that core belief. The ACA as planned is not working in Alaska because of its unusually high costs and small risk pool. Whatever your ideology, if the Alaska legislature did not do something, people would die.

The situation in other states is not as extreme as in Alaska, but it’s getting there. Congress has the luxury of dealing with the problem abstractly and ideologically, but that leaves state legislatures facing the problem directly in the lives of actual constituents and the actual hospitals and medical providers in their towns and cities.

Expect more actions like this Alaskan bill.