Tackling and overhauling the whole healthcare financing system is just plain too big to do by way of one 2000-page bill/law for which politicians and their unelected appointees write the regulations and policies/procedures for carrying out such a monumental task.
Consider:
The USA's population is: 315 million
Canada's population is: 35 million
We should have been addressing the goal of getting the uninsured and pre-existing conditions people insured, and that is why 38 states already HAD high-risk health insurance risk pools before this legislation began:
States That Have Risk Pools But politicians never talked about
that.
Also, efforts should have been keenly
focused on getting the people enrolled in Medicaid who were qualified for it before this attempt at whole-system
demolition, but simply did not do it out of ignorance, apathy, whatever.
Burning down the house to remodel the living room is the best description of what is happening via the massive legislation.