I imagine it will, in practical terms, be harder to undo the ACA as time goes on, but one thing would have made it really hard:a public option. At least, a public option that was around for a few years.
Anyway, perhaps some of us didn't say it quite so loudly when the debate was on, but the basic reason for wanting a public option is that private health insurers are incredibly wasteful. They're costly skimmers. They don't actually do anything useful. Perhaps vanquishing an entire industry with the stroke of a pen wouldn't be such a good idea, but the public option would've let it be phased out slowly.
