I agree with ED about ACA and Republican opposition to it:
When ideology becomes so important that people no longer realize the limits of their own ideas, good ideas are drowned in favor of purity, the perfect becomes the enemy of the good, the abstract becomes the enemy of the tangible. The ACA may be weak tea – Wyden/Bennett would have been better, single-payer would have been better, both would have been cheaper and more effective – but the ACA is certainly a step up from the status quo. Anyone with a pre-existing condition could tell you that.
But I think there is more to it than ideological purity. ACA is fairly similar to legislation proposed by Republicans in the early ’90s. Yes, it’s true that today’s Republicans are much farther to the right than they were in the ’90s, but it’s also true that Republican opposition to Clinton’s plan in the 90s was in part openly based on the idea that health care reform would be a boon for Democrats. It wasn’t purity but cynical politicking that did it in.
I think there’s an attitude among today’s Republicans that is, essentially, fuck it, who cares if health care is fucked for now as long as Democrats get blamed for it, and when the Glorious People’s Conservative Revolution comes, the magic of the free market will fix everything, in the meantime chaos and dysfunction are our allies. It’s the domestic analogue of the J Curve.
I don’t claim all conservative think like this — I doubt that Mitch Daniels or Mitt Romney do, for example — but conservative punditry generally does.