Did it ever occur to the GOP that they could work with the Dems to improve the ACA and get the problems fixed? No. Poisonous politics will not allow. Compromise is dead.
For example, they could allow a public option for any state that has been abandoned by insurance companies, or if insurers do not offer affordable premiums except for plans that have very high deductibles and poor benefits. Single payer (Medicare for All) healthcare should be encouraged in any states that elect to take the insurance industry out of primary care coverage, limiting insurance companies to providing only supplemental coverage, as with Medicare.
Ask the Medicaid recipients to prove their low income status and also pay some minimal copays that they can afford, so they have some skin in the game.
Provide government support for low cost, non-profit clinics that can offer affordable cost coverage to the uninsured, or patients that need to see a medical provider before an illness becomes chronic and expensive to treat in an ER.
Let the HHS Director negotiate prices for prescription drugs.
And if states still prefer the myth of “free market healthcare”, let them suffer its consequences.