Here's the problem with the ACA. It's simple.

[Sarah Ibarruri]

29. We know, we know. It's the 1st step toward something that resembles health care for all

It's not the final product. This is the first step. Single payer would NEVER and I do wish to repeat that, NEVER have been approved with the predatory Republican assholes in Congress. EVER. This approximates it. IN fact, I think it's amazing that even this got passed, really. I'm still in shock. I mean, for the first time all those people with pre-existing illnesses can get insured. There are a lot of firsts.

Now it will have to be tweaked until it functions properly

Once it is tweaked (and it will take time) it will be OUR TURN to slowly turn this into a fully single-payer system and take it from the insurance companies. We first need to change the country's mind, turn it from right wing (which it still is - it entered some really sick right wing nightmare in the 80s and it's still very much there).

I totally agree with you that he doesn't control the insurance companies, but he got the darn thing set up, and now we have to move forward with it.