That's fair - I'd say if Hillary Clinton somehow becomes President, a huge mistake in my view, you can forget about any comprehensive change to the ACA. It will be left to collapse unto itself. The only chance for comprehensive reform will be through a Republican President, someone like Jeb Bush, who can move away from the mandates and push to have broadened coverage of those without insurance at the moment - this is what should have been done in the US before the ACA. It would be, in effect, a federally funded complete expansion of Medicaid to cover those without insurance for financial reasons. In effect, a self-insurance program.
That will, over time, move the nation towards a single payer system that is supported by the majority of people. And you're right, it wouldn't be quick and it won't be easy, but a Clinton Presidency sets it back a decade and perhaps the ACA collapses under it's own inefficient weight.
You bring up interesting points, though I'm not sure I (always) see the same results you envision.
Why is it you believe Mrs. Clinton would let the ACA collapse upon itself?
(she was a strong healthcare proponent during her husband's presidency, but got beaten back by the insurance industry then, from my best recollection)
I do find it interesting you feel a Republican could save it, but with someone like Mr. Bush you might be right, seeing that he seems extremely moderate to me. But I'm still not sure I see the GOP as a whole getting behind the ACA or universal healthcare at this time.
And you are right in that there is the possibility of MedicAid expansion (though I originally felt there could be a MediCare expansion, possibly starting with a buy-in, whether subsidized or not). But yes, the MedicAid threshold was increased 125% under the ACA, and it could be progressively bumped-up over time.
I wouldn't doubt that under the umbrella-guise of the ACA, several of these tacts merge and morph over the years into something approaching universal coverage.
But I'm dead against a means-tested
'government picks winners & losers system', like the current ACA and MedicAid. If there's a benefit to be provided, it should be provided for all, equally.
[BTW
CanadaJohn, my grandfather migrated from Poland to Canada firstly, living there for quite a few years while bringing in tons of family members, before eventually ending-up in the States. Consequently, I've got relatives from Quebec to Vancouver and we visit each-other occasionally, so I've had some very basic familiarity with the Canuck health system since the early '70's - that's why, in part, I want us to enjoy universal healthcare here.]