The insurance companies were consulted and included while the law was being drafted (over decades, because remember a lot of the groundwork was laid by the Repu

The insurance companies were consulted and included while the law was being drafted (over decades, because remember a lot of the groundwork was laid by the Republicans during the Clinton Administration). But it's not all rosy for them. They accepted the downside of this approach to healthcare reform because they saw potential alternatives as being much worse. A single-payer system would put the lot of them out of business, so they were willing to take some lumps to ensure that they're part of the American healthcare system moving forward.