More than a decade later, the GOP has still yet to present an alternative healthcare plan to the ACA. Actual leftists have continued to push and argue for a true single payer system.
The ACA Is far from perfect but it was a significant step up from what we had before, and the party that spends all of their time trashing it has never made any sort of serious attempt at creating any sort of alternative.
A principled "small government" alternative would be ... nothing. Their view is that the federal government should have no role in providing health insurance.
Sure, but that's not actually the position of the GOP or their constituents, or even the pre-ACA situation.
The amount of people that actually want the government to have no role in providing health insurance or health care in this country is vanishingly small.
Which is a very nice view, until the federal government has to start getting involved anyway because someone has to scrape the rotting corpses off the streets.
Ultimately the health and life of the citizens is one of the most foundational concerns of any nation. You literally can't just ignore it. You have to face it, whether you want to or not.
Ben Carson has not put forth anything even remotely resembling a practical replacement for the ACA. He hasn't even been able to put forth any sort of consistent plan.
This wasn't about ending that system, it was about preserving that system and further entrenching it at a more substantial cost to the end users of healthcare, who tend to be some of those least able to afford it.
This idea that there's just left and right is very quaint. The bigger divide today is pro- and anti-establishment, plenty of the 'right-wing' Trump voters were also celebrating what happened to Brian Thompson.
Meanwhile, the ACA was quite frankly a love letter to conservatives.
It kept the US profit-driven system on life support, and it's a form of the same system proposed by Nixon, and again by republicans during the Clinton administration's push for healthcare reform, and the system enacted by Mitt Romney in Massachusetts.
The only reason republicans opposed it on party lines during the Obama administration was politics: they were forced to denounce the system they loved due to their status as the opposition party. In another universe they would've celebrated their president signing it into law.
Actual leftists are probably fine with ending the current system because it will bring so much pain to the voting public that it might actually get them off their asses to bring in single payer. As the saying goes: "You can always count on Americans to do the right thing, after they have tried everything else."
