The ACA is good because it banned several horrible things, but it could be better.

ACA was a compromise to get something changed. It was never supposed to be the final result. Republicans turned it into a boogeyman that had to be undone instead of doing the right thing for their constituents and proposing a better solution. It was always funny to see red states quote the soundbite that they hated Obamacare, then say they didn't need it as long as they had their ACA.
- Back before Trump 1, every Republican ran on repealing ACA. So in the second half of Obama's second term, GOP had the House and Senate but not a veto-proof majority. They sent something like 80+ bills fully repealing ACA. Of course they all got vetoed.
  Trump runs on getting rid of Obamacare and wins, maintaining the GOP majority.
  Not a single bill lands on his desk fully repealing it. It was all performative. They knew their constituents would yell at them.
  Let's not forget the "We'll have a new better healthplan in 2 weeks" nonsense.
  Now here we are again. GOP controlled House and Senate and a president that is hell bent on destroying anything any Democrat did.
  ACA still hasn't been repealed.
  
  They're destroying the federal government, so some parts can be replaced by corporations and so that corporations can do what they want. These people saw cyberpunk and thought of it as something to achieve.
  
  Maybe not in its entirety, but they are cutting medicaid right
- Yeah, there are a lot of comments here berating it, but it barely passed as it was and has only been on the chopping block since. If people want something better, they need to work to help the republican voters demand it, cause it isn't the democratic voters holding Healthcare change back.

The ACA did give incremental change in updating things like the long overdue “no coverage for pre existing conditions” bullshit. That was admittedly a big win.
But the individual mandate with no financial assistance was tone deaf at best and corrupt at worst. People who were uninsured were uninsured because they couldn’t afford it, not because they thought it was cool to not buy health insurance. Now they were forced into a position of buying expensive coverage or penalized financially for not doing so. Huge win for the privatized insurance industry, which has been doing amazingly well since the ACA. And this ultimately weaponized a generation against healthcare reform! I would bet at least some trump voters are disgruntled people that are still furious that despite being barely able to get by their government forced them to spend $3-400 a month on a bullshit health plan that covered nothing because it still had a $4000 deductible
I would buy the whole “this was a compromise on the path to something better” if there was any movement whatsoever on healthcare reform since. The ACA was fifteen years ago. I work with high schoolers that are older than the ACA.
And what major reforms have we seen in those years? Not a ton:
Repealing the individual mandate - republican win in 2017, pulling those disgruntled voters in
Alt health plans - pooled and short term health plans. Short term health plans reintroduce denial based on health history, pooled plans are potentially unstable based on the pool, both limit coverage options fairly substantially compared to traditional plans
Medicaid funding cuts
Prescription drug pricing changes - some wins here but also some concerns about potential access to novel treatments for people on Medicaid and Medicare
The ACA did far more bad than good. Like typical democrat shit the good could not occur without padding the pockets of the donor class at the expense of the worker class.
- The ACA immediately lowered the cost for insurance. I know because in 2007 my healthy, 28yr old, non-smoking ass tried to get private health insurance. The cheapest, emergency-only coverage I could get was over $600/mo. After the ACA was enacted I could get a similar plan for under $200. I hadnt had health insurance for 10 years by then cause I was kicked off my dad's when I turned 18, not 26 like it is now.
  
  People under 30 had a special low cost catastrophic plan... Those savings were gone by the time you hit 30 and cost has been rising higher than inflation for over a decade now.
  With shittier outcomes
- Yeah, who could forget how hard the donor class has been working to protect the ACA against people trying to get rid of it, because of how much they love it.
  Wait
  I feel like maybe something else has been happening. Help me out?
  
  I feel like there’s no way you read my entire post in the 4 minutes since I posted but
  The donor class wants to protect the flawed ACA because the benefits it brings, like protections against pre existing health conditions, are important. I said as much. They also don’t want to walk back what they see as the only bit of progress that has occurred, which is understandable
  But do they really “love it”? This is battered partner syndrome. American health care is abusive. We can’t possibly love this. But we are so entrenched in this garbage system of administrative waste and obnoxiously overpaid staff that do not bill we cannot envision a better future
  Early in her campaign Kamala co opted Medicare for all and described her proposal. On one hand it was nice to see someone finally describe healthcare reform again (though she was silent for the rest of her campaign). But on the other much worse hand her system was horrible, continuing the system of privatized Medicare with a 2 lane system. Basic Medicare for all Americans but premium Medicare via private companies if you had the means. This is an improvement, for sure, but ultimately it is the ACA and all of its flaws all over again. Excessive administrative overhead raising complexity and costs significantly, a 2 lane system creating a class divide and confusion for consumers as providers will not all work for everyone, and a return of the individual mandate via taxation (which to be fair is necessary, we need young healthy people paying in, but it’s not fair if it results in them getting substandard insurance again to fund the plans of the rich!)
  The ACA and Kamala’s proposal, which is a more aggressive version of it co-opting Sanders terminology that polled well, is class warfare. The donor class works to defend it because they do not realize they are being sold a pittance and that they need to demand more

The ACA is not good. It was a clear example of our political system failing and capitulating to capital interests and the fact that it exists and is in fact arguably the only liberal polical "success" in my lifetime is emblematic of the utter and complete failure of the American political system.
- The ACA is not good.
  Incorrect, see below for many examples and arguments
  It was a clear example of our political system failing and capitulating to capital interests
  Absolutely correct
  the fact that it exists ... is emblematic of the utter and complete failure of the American political system
  You'd rather it didn't exist?
  is in fact arguably the only liberal polical “success” in my lifetime
  The IRA reduced climate change emissions by about 40% from the peak.
  Income inequality has actually been going down for the last few years, is that not a good thing?
  Marijuana is legal now.
  It's not really "legislative," so maybe this is sort of backing up what you were arguing in fact, but policing changed radically between 2014 and 2021, to the point that a lot of the abuses that were commonplace in 2014 actually are now these crazy outliers, and are usually punished with criminal charges for the cops.
  I've talked before about how I feel like there are people who like to "paint the tape" of a comments section by leaving a handful of super-forceful comments in one particular direction, to paint the narrative they like to paint, if the comments section starts to develop in a way that they don't like. Try sorting by "top" and compare it to the current comments section, if you want to get a better picture of what the consensus is.
  
  I’ve talked before about how I feel like there are people who like to “paint the tape” of a comments section by leaving a handful of super-forceful comments in one particular direction, to paint the narrative they like to paint, if the comments section starts to develop in a way that they don’t like. Try sorting by “top” and compare it to the current comments section, if you want to get a better picture of what the consensus is.
  Yeah, I think you're right. I poked my head into these threads to see what was up, mostly because I was confused as to why Obama showed up on BlueSky talking about ACA when there's other stuff going on (trying to understand what he's attempting), and for some reason this topic seems to have gotten the weirdos stirred up hard, mostly as you said with very confidently-worded assertions that appeared suspiciously quickly.
  I wonder if it's because they're trying to capitalize on any old hot-button emotional spittakes left over from Obama's days as president. I mean, there's a lot of very important things going on with DOGE and it might serve certain interests well if we're distracted from THAT danger and instead talking about Obama who doesn't seem to be doing anything pertinent at the moment.
  
  The passing of the ACA is something I see as a massive failure. How can we not? There was a chance to push for a real solution, universal healthcare, to get the private companies out of healthcare, and the DNC didn't even try to make it happen.
  Obama caving on universal healthcare was a warning sign of the kind of weak sauce that we're seeing from many Washington Democrats this year, people who simply don't believe in supporting the average American. If you didn't see that at the time, I don't blame you. Many people were fooled. By now, though, it should be apparent to all.
  You want to argue that the ACA itself is good, but that's a meaningless statement. Good compared to what? Meh. Putting a bandaid on a failing system that is now failing worse than it was a decade ago is better than nothing, sure, but it's not particularly admirable.
  I'm not the previous commenter, but in answer to your question, would I rather the ACA not exist? Of course I would! Anyone with half a brain who cares abut human beings around them would. Give us universal healthcare already. To hell with the ACA. Don't give us broken systems that private companies will game to get rich while depriving our loved ones of live-saving care. We've had enough of that already... But many Americans are blindly patriotic, honestly believe that America is the greatest country in the world in every way, and can't realize how much better life is in other places that actually have half-decent healthcare. So we'll see if things ever take a change for the better.
- Yeah but people like you talk about it in a way that misses the important point fucking entirely. The ACA is the best the Republicunt party would let Obama get away with at the time, and they fought like hell against it.
  
  Though the Republican party does seem to be getting away with a fucking lot these days...
  
  That's now what I remember, though. I remember the Dems barely even trying to get universal healthcare. They quickly threw in the towel, because (in my opinion) they wanted to appease their funders.

All those statements are objectively true.

Broke: ACA helped a lot of people get access that were fucked before.
Woke: ACA was just for giving rich people money.
Bespoke: The ACA was the democrats leveraging a mandate to make a deal with the heath insurance companies that funded their campaigns to give concessions on the most heinous aspects of their industry in return for ever increasing profits.
- Woke: The ACA was largely a giveaway to the insurance companies. It fixed the system from being cartoonishly killing-people-on-purpose evil, into at least featuring a passing resemblance to decency such as would make sense for any other industrialized country, but it did basically nothing to fix the systemic issues at play in health care, because of systemic issues in our politics that make government on behalf of the people basically impossible. And, things have gotten back worse again since it happened in several terrifying ways.
  Bespoke: Let's get involved in fighting to make the system better, including kicking out a bunch of the bums who are carrying the mantle of "liberalism" while basically being corporate whores. The success of the BLM protests, the legalization of marijuana, and of course the historical precedents of big things like OSHA, social security, medicare, and so on, make it clear that change is possible if we fight hard enough for it.
  Broke: Fuck the Democrats, let's let the Republicans win, what's the worst that could happen.

Dead CEO was enabled by the ACA to kill people for profit.
Sure it covered more people but over all healthcare quality went down and corporate parasite profit went up... Because ACA was drafted by health insurance and pharma.
Until the corporate trash is removed the process, we gonna keep getting more and more fucked
- The speech of someone they never had to worry about healthcare being denied because of “pre-existing conditions” or losing access because you turned 18.
  
  I happy that ACA worked for you dear... That's all what matters here. We should make our national health policy around your needs. It is only fair.
- Is your impression that insurance companies weren't killing people for profit before the ACA came along?
  It was much worse. Michael Moore did a darkly comic piece about a man who was guaranteed to die without treatment, whose insurance company was denying him treatment, and they showed up at the insurance company's corporate office with him in tow and performed a funeral for him there. They eventually approved his coverage. But they had to work for years and years before they were able to recover the killing-people-on-purpose abilities that they had before the ACA became law, and they're still missing some of them. They used to straight-up kick you off your health insurance if you got sick in a way that was going to be expensive for them to treat, for example. Now at least they have to be more subtle about it.
  
  Key bench mark for health insurance is something like life expectancy... Among other factors.
  The US life expectancy has been going down since mid 2000s.
- over all healthcare quality went down
  Source?
  
  https://www.ncbi.nlm.nih.gov/books/NBK600454/
  Declining life expectancy is indirect but a very telling indicator.