It's all about herding as many people as possible into the insurance pipeline. Both the uninsurable AND the people who have realized it isn't worth it.
We had a choice. We could pass ACA and you would call us fascists, OR, we could make Medicare cover everyone, in which case you would call us communists. Or, we could leave it like it was, were millions of Americans could not buy insurance at all, which caused their medical expenses to be shifted to the insured population, in which case you would call us capitalists, but people with heart disease and cancer died for want of medical care. I guess that I will have to live with being a fascist then. But, since you are on Medicare, I guess that makes you a communist
You* did have a choice. Democrats could have done anything they wanted. And they chose to divert legitimate public demand for health care reform into another corporatist sellout. And they made the mistake (the same mistake Republicans are on the verge of repeating) of passing it all on a slim partisan majority.
Also, spare me "but, single payer!". Democrats didn't have consensus on that, even amongst themselves. All they could really agree on was that a fat payday for their lobbyists was sure to help the cause!
* I'm assuming, fwiw, that you, personally, had nothing to do with passing ACA. If you did, I'd love to hear more about it!