Adults understand that while the ACA has its flaws, the intent was to establish a framework that could be tweaked by subsequent sessions of congressional representatives who took their roles seriously. Children, ideologues, and opportunistic assholes say things like Clownstick does in the above tweet. His essential position on this is "rather than work on the flaws and improve the product, let's burn this fucker down and make a new one."
Never mind that the ACA was the culmination of efforts that began in the Truman administration, never mind that their "plan" was a vicious joke, people will die because these fuckers are content to let the ACA twist in the wind and implode. This should clarify to those who might still be wondering whether they are really as horrible as they seem. They're probably worse than you think.