After six years of rock-solid defense, top healthcare advocates in the Democratic Party are now willing to acknowledge that the Affordable Care Act has fallen flat on affordability.

At the Democratic National Convention this week, some of Hillary Clinton’s closest allies on healthcare are setting her up for a major battle to lower the cost of care, an issue they said needs to top her agenda as president.

“Healthcare costs, I really see as the next generation of healthcare reform,” Neera Tanden, the president of the Center for American Progress, said at a luncheon in downtown Philadelphia on Wednesday.

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