The ACA issue is not whether it is good legislation or not. The issue is that si many USA citizens are one medical emergency away from bankruptcy that the fear of those families will be translated into action.
If ACA is defeated we will still have problems which we see coming from having no coherent national health plan. The two most obvious problems are families which are reduced to utter poverty by a health emergency and hospitals which go bankrupt due to too many patients coming in through the ER and who are unable to pay much of their bill.
This is something that happened to St. Vincent's Hospital in NYC in 2011. This was the only hospital on the Lower West Side of Manhattan and was the hospital nearest my home. St. vincent's Hospital went bankrupt for a second time in a decade and closed its doors due to the problem with patients coming in through the ER who couldnot paytheir bills and due to a large number of HIV/AIDS patients who had used up their lifetime insurance limit of $1,000,000 in healthcare expenses and had to be treated with only patial compensation from medicaid.
This endangers me personally. I have excellent health insurance, but I am now a twenty minute (or longer) ambulance ride away from Beth Israel Hospital or Roosevelt Hospital ERs. I am a seventy-four year old guy with a heart condition, and I may die in the ambulance stuck in Manhattan traffic.