Paul Ames

I don't think it was poorly designed so much as constructed to avoid political opposition so it could be implemented; even though it's a bit of a "kludge", as Paul Krugman describes it, the same plan is working acceptably in Massachusetts. This is the same plan pushed by conservatives during the Clinton administration, so I don't see how that was too fast or lacking in transparency. It was passed in a partisan manner because that's the only way anything gets passed these days. And the implementation has been hobbled by the Supreme Court decision allowing states to opt out of federal Medicaid expansion. The states who were ideologically opposed to the law promptly did just that, and also refused to set up their own exchanges, forcing all of their residents onto the federal exchange, which was not expected.

As far as forcing changes, most schools and many medical institutions require vaccinnations ( a form of health care), and some private insurers already refuse to cover tobacco addicts, but that's really a straw man argument, since there is nothing in the ACA like that. The SNAP restrictions were passed by politicians who disagree with the program ideologically but lack the ability to kill it entirely, so they intefere with it any way they can, similar to what they're doing with the ACA.