I am in agreement with all of this except the last word. These factors you mention did not lead to the ACA's demise, not yet. But they did result in an even more flawed result than the untampered with ACA would have produced. You're certainly right that inept and bought poiticians on both sides led to a flawed ACA; the ratio of republicans to democrats in the poison pill business was, however, something close to 20:1. There was a critical component in the original plan that had the potential to result in a plan that would eventually, and gradually, undergo metamorphosis into medicare for all with attendant efficiencies and cost saving. That component, was the public option. It was killed by a "democrat" in the Senate with encouragement and help from his Republican colleagues. The democrats withdrew it from the Bill when they realized they had no chance to get the ACA through both houses as long as the public option remained in the Bill.
These observations suggest a way forward. Leave the ACA intact as it stands now, then restore the missing parts that are needed to make it half way functional. Then literally force all states to expand medicaid by making it too costly for them not to. Begin enforcing stiff penalties on those who fail to sign up for insurance. And then add the Public Option. Eventually everyone will voluntarily move to the public option because private insurance can not compete. As more and more people choose the public option, and they will, medicare will acquire more and more leverage over pricing, and the portion of the pie left to private insurers will be slowly choked off. It will take about a decade for virtually everyone to be covered under medicare, i.e., "the public option". The transition would be subtle, smooth and relatively painless for the vast majority.
