The ACA program is a failure. The insurance that is being sold is too expensive for many who don’t have insurance and too expensive to use for many who have purchased the plans. I don’t know if the plan could have been salvaged if both parties cooperated, but since they don’t, it simply cannot be salvaged.
Our system is expensive and everything we do seem to add to the expense. Medical education is super-expensive and doctors must rake in the bucks once they start practicing. Naturally US salaries are much higher for Doctors in the US than in other countries. I was once treated by a doctor who was working in Little Falls, MN, while his family was in Kansas City. It’s has to be expensive to have 2 households like that. We all pay for those larger costs. We all know that CEO salaries are outrageous in the US, that too and the salaries of other upper level managers adds to the cost of medicine in the US. Another reason is the cost of prescription. Prescription drug prices are rising at 10 times the rate of inflation. That isn’t natural. (http://time.com/money/4406167/prescription-drug-prices-increase-why/) Everything in the system is designed to bring in money, what is worse is that those who need healthcare are subsidized by those who pay for it and not society as a whole. That is a critical flaw in the ACA plan.
No amount of tweaking will fix this. Perhaps the best thing to do would be to scrap it entirely.