The real challenge facing progressives today is not a public disappointed with the ACA, the real challenge comes from the ongoing efforts of that cadre of grifters and psychopaths, the leaders of what others have labeled ["movement conservatism"][3], what is more accurately called "Reaganism". 

The great triumph of Reaganism is not convincing Americans that given the choice between meaningless suffering and accepting help from the government, the American thing to do is to go on suffering. No one believes that! What Reagan did was convince Americans that government was, by its very nature, incapable of helping people in a fair and cost effective way. Also, he pointed out, it frequently helps black people.