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Edited by Smith5084: 1/27/2016 1:34:14 PMIt's honestly more to do with Medicare and Medicaid payments than it does the ACA, but the huge expansion of who was eligible for Medicaid has only made the problem worse.
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So, tell me this, if you have option A, to make $100,000, versus option B, to make more as a specialist, what do you choose? My friend went into gastroenterology, not because he would make less otherwise, but because that work interests him. And he very strongly supports the Affordable Care Act, so much so that he has actually gone to DC and lobbied for it. So he doesn't fit your assumption in the least bit.
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No, particular state governors declining Medicare expansion in their state is the problem. If that expansion had occurred in every state as planned, literally everyone who has too low of an income to afford insurance would be on Medicare.
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They just all happened to be Republican... :/