Do nothing and less than half of all Americans would have been able to afford healthcare insurance by the end of the decade.
The ACA is a bastardized program passed by a political party vested in keeping millions of disenfranchised people in this country from being denied basic health care.
The other party has repeatedly demonstrated they don't give a damn about anyone incapable of paying for private health insurance and would rather those people die and reduce the surplus population.
Hopefully one day, the majority of Americans wake up and realize they can pay less money and get better healthcare outcomes by simply adopting the system successfully used by the rest of the civilized world.
Sadly, until that day, the ACA is as good as it gets in the USA when it comes to healthcare.