Republicans have subverted and sabotaged the ACA from the beginning. We'll never know how well the ACA could have worked because so many of the mechanisms that were created to control costs have been dismantled by Republicans.
The Republicans are giving people a lot of pain and suffering but ultimately they are guaranteeing the acceptance of government controlled socialized medicine. It is guaranteed to come to America because people are more global, they look at systems outside the United States and realize that what we do is crazy and unsustainable.