This is coming way too late, but I'll hop in. The ACA has had three demonstrably positive effects on health care for me.

One, it has made health plan benefits dramatically easier to understand. Now, if I didn't bother to research about HMOs, PPOs, HSAs, and other plan types and insurance language, it might still be a bit confusing. But ACA's tiered plan structure made defined benefits much clearer to me as a subscriber. I am self employed and young, but I never wanted to be in a situation where medical expenses could bankrupt me, so I knew I wanted an HMO with a low deductible even if it meant a more limited network. I chose a platinum HMO. My benefits are clear and I understand them.

Two, it reduced the cost of HMOs for single subscribers NOT using an employer option in California. People always define insurance cost relative to what their employer will cover. I pay my entire premium out of pocket. Pre ACA, plans may have had greater coverage and larger networks, but the ACA's minimum benefit requirements allowed insurers to offer scaled back versions of their "premium" plans as ACA options. Is my network smaller? Yes. Are my copays and deductibles a bit higher? Sure. But I still have a very small deductible and standard HMO plan features that make basic things like urgent care or specialist visits copay rather than deductible based.

Third, I can deduct this on my taxes. That does help mitigate some of the cost.

I understand that many people feel "forced" into employer options because that's what their employer will cover, but pricing out plans on your state's insurance market, considering tax benefits and possible premium assistance, and considering the fact that your marketplace will likely offer ALL types of plans are all important.

I agree our system sucks, and I am all for single payer. But I also don't have much sympathy for the special snowflake mentality many people approach healthcare with. This country has a lot of patients, and comparatively very few physicians. You can't always have the doctor, hospital, or office you want. Lots of other people want those things, too. Socialized single payer systems generally mean even less patient choice on these things. I think that's fine, but many Americans are used to having "the best" doctor for their needs, and will choose insurance on that basis. Single payer would inherently require a lot more flexibility on our part. Doctors can't magically see everybody that wants to see them, and insurance networks help mitigate this (albeit unintentionally) for the time being. Single payer would likely mean something far more draconian than the current system.