Any jackass can kick down the barn...

[Vox Moi]

2. But the real target is the barn-builders

Destroying the barn is secondary to destroying the will to build one.
The target is 'government' and that means 'We, The People', acting together in our own best interest.
The Republicans could care less about most of the 'issues' they bemoan, and the ACA is a case in point.
Big Insurance and Big Health Care get a pretty good deal from the ACA, which leaves the basic paradigm for health care in America intact, provides price support for insurance policies and millions of new customers.
I don't think that any Republican truly believes in Death Panels or the idea that the ACA is the biggest disaster in American History or that it represents a government takeover of anything.
It's all about destroying the confidence in Government. Period.
If there is one statistic that Republicans can be happy with it is the approval rating of Congress.
The lower, the better.