It matters!
When did we all become a bunch of lemmings dutifully walking off the cliff saying, "One way or another, it won't really matter?"
If you look at the ACA it is built on a funding scheme where the three major components are 1) pulling money out of Medicare, 2) penalties on employers of more than 50 that don't provide full time employees with health coverage, and 3) taxes on the rich....and anybody that uses healthcare, tanning beds, medical devices, etc. Additionally they collect 10 years of taxes for 5 years of benefits.
All those revenue streams are supposed to support between 15 and 20 million people that are currently uninsured and is supposed to be revenue neutral. What happens when more than 20 million people show up for coverage under ACA? Well, the penalties to employers might go up, but the other two portions of the funding scheme can't be expected to increase. The plan will collapse under its own weight.
It was written that way and I don't think the ACA can last much past its first 10 year cycle before we are forced into a single payer plan as the only option. The government will have destroyed any way back.