I’m not interested in re-litigating the health care wars, but I think everyone can agree that the delayed implementation for the benefit of a better CBO score was debilitating to the policy, at least in political terms. Because now we’re starting to get the first reports of how Americans are faring in a post-Affordable Care Act world, and because practically nothing that the law has created helps Americans get insurance, they only see that world growing worse:

Nearly 59 million Americans went without health insurance coverage for at least part of 2010, many of them with conditions or diseases that needed treatment, federal health officials said on Tuesday.

They said 4 million more Americans went without insurance in the first part of 2010 than during the same time in 2008.

“Both adults and kids lost private coverage over the past decade,” Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, told a news briefing.

Among adults age 18-64, and in case you didn’t know that’s the voting age, 22% are uninsured. Half of the uninsured have incomes over the poverty level. 40% of them have one or more chronic diseases. This is not about being young and libertarian and free, this is about not being able to afford health insurance.

Obviously the Great Recession is the leading cause of this. But when Democrats spend 16 months on a landmark health care law, and the first data after passage is that the ranks of the uninsured went up, it threatens public support for the law, already at a low level. And with Republicans gunning for repeal, it just provides them more ammunition.

The swelling numbers of uninsured will make it that much harder to claim universal coverage once the full ACA kicks in by 2014. At the current trajectory, the exchanges will allow barely half of the uninsured to get affordable coverage. And we all know about the relative quality of that coverage.

Another trend in private health insurance we’re seeing is cost-shifting, in this case up to wealthier customers. Basically, workers are paying more and more for coverage, and getting less and less with it. This is the system we propped up in the ACA.

One Congress is not bound by the actions of another Congress. As much as people like to think that repeal can’t happen, the weakening of the political coalition for this particular legislation pushes us in that direction. If people think that the best Democrats can provide is 59 million uninsured and rising costs, they’ll listen to whatever nonsense the other side has to offer.