The ACA barely touched employer-based insurance. It definitely did not make things "modestly worse for most people". You are blaming the ACA for problems that

The ACA barely touched employer-based insurance. It definitely did not make things "modestly worse for most people". You are blaming the ACA for problems that existed in the health care system before the law went into effect. Any degradation of care for "most people" is because of crazy year-over-year cost increases that were already happening. And the people who had pre-existing conditions before the ACA were well and truly screwed. That didn't mean insurance was expensive for them - it meant insurers wouldn't sell them insurance at any price. My personal anecdote: Pre-ACA, I was denied insurance by Aetna at age 35 because I had "acid reflux" and I had injured my neck in my 20s (even though I had no problems with it at the time). Then all the other insurers denied me, because the first question on any application was, have you ever been denied for health insurance? The annoying thing was the ACA had already been passed, but had not gone into effect yet - so until that happened, I guess it was just business as usual for the insurers.