[cmurf]

PPACA is the incremental change. There wasn't the political capital to effectively destroy the health insurance industry by leaving only VIP insurance (really it's not insurance, it's a "pay extra to cut in front of the line" product).

Democrats apparently didn't have the votes to even make Medicare or Medicaid an optional buy-in, to compete with marketplace insurance. This in particular is necessary in a huge land area of the U.S. where there's only one or two insurance providers.

[masonic]

  Democrats apparently didn't have the votes

Democrats had the only votes and the only say in every element of "Obamacare". Republicans were not even allowed to see the bill before the vote was taken, hence zero Republicans voting for it.

[dragonwriter]

> Democrats had the only votes and the only say in every element of "Obamacare".

That's not actually true (Republicans had a significant say, even though thet universally ended up voting no), but even if it was the public option had long been controversial among Democratic politicians despite it (and even moreso simple single payer, which had a majority support ) long being overwhelmingly popular among Democrstic voters and having stronger support nationally than the purchase mandate w/o public option approach.

> Republicans were not even allowed to see the bill before the vote was taken,

Yeah, they were, they were also involved in the Committee process in the Senate in which it was drafted. They also filibustered it for quite a while, which gave them even more time in which to read it.

And of course Republicans in the House had still more time to read it, since it was voted on in the House after the vote in the Senate.

There are lots of reasons you can argue might have been behind Republicans voting against, not being allowed to read it is not one of them.