Basically, Obama and the advisers he picked decided that the only way to pass a health care bill was to give the Republicans and the corporations everything they wanted. They struck a deal with the insurance companies, the drug companies, the hospitals, the doctors' organizations, etc. to give them everything they wanted
The only problem wit this line of reasoning is that the Democrats had a majority in both the House and the Senate when the ACA was passed, it is 100% theirs, they pushed it through over the objections of many Republicans. They did not need to placate the Republicans to get their cooperation, and both parties are in bed with the corporations. Sorry, this lemon is 100% on Obama and the Democrats. Not to say the Republicans would have done any different or better, just that they were not an issue in this case.
Established technology tends to persist in the face of new technology. -- G. Blaauw, one of the designers of System 360