I would much rather have had the Democratic majority in Congress pass something akin to H.R. 676, the single-payer bill proposed by Michigan Rep. John Conyers, or S. 915, the one introduced by Vermont Senator Bernie Sanders. It's unfortunate that these two proposals didn't gain more mainstream support outside the Congressional Progressive Caucus and MSNBC liberals, because a national single-payer program would be significantly better than subsidized market bureaucracy.
Unlike H.R. 676 and S. 915, the Patient Protection and Affordable Care Act (H.R. 3590) did not include a mechanism that would help people who lose their jobs; the two single-payer bills allow the Labor Department to find the displaced workers new jobs, pay for education necessary for that job new job, promote job fairs, etc. The Affordable Care Act doesn't have any mechanism to help those that lose their job, and in some ways actually promote job loss- say by corporate consolidation. As health insurers are exempt from most anti-trust laws, and the "exchange" marketplaces will only hasten the market's natural trend towards monopolization, small and uncompetitive companies will be quickly brushed aside and all their workers may find themselves without jobs.
The Affordable Care Act is not "socialist" in any way. It uses tax power to coerce participation in a for-profit "market". I hate to say I agree with the Republicans, but it should be repealed, given that it is going to be replaced with a comprehensive single-payer program instead. That said, having the Act is better than not, because there are a few decent elements to it: staying on your parents' insurance until age 26 instead of 18; requiring that at least 85% of the monthly premium goes directly towards healthcare, rather than the 70-80% before the Act was passed; covering basic preventative care, like simple antibiotics, vaccines, physicals, etc; trying to expand Medicaid so that more families in poverty can more easily enroll; expanding HIV/AIDS and cancer funding; renovating inner-city hospitals and clinics; expanding college debt-forgiveness programs for those who want to work in primary-care public healthcare; etc.
It'll kill some jobs, and it'll hasten insurance monopolization. This country should have adopted single-payer generations ago.
Edit: I thought it would be interesting to add that both Rep. Conyers and Sen. Sanders are associated with the DSA.


