The ACA was handicapped by the fact that the entire Republican Party opposes any action to improve the health care system, and half of the Democratic Party is owned by the insurance and pharmaceutical industries, including Obama's chief of staff at the time. It net-improved coverage, but did so by doing the policy equivalent of shuffling around deck chairs on the Titanic.

Other first world countries successfully use insurance-based models in their health systems. Some just run it directly by the government. All perform better than the US system, and for less money.

None of them - no country on Earth - has a successful, humane health care system that doesn't involve taxing somebody in some way. So if you're going to say "the health care system is bad, and taxes are bad", the onus is on you to convince us how it is possible to have a good health care system without government involvement, a notion that would seem absurd to most everybody else on the planet, including health policy experts.