Simply having ACA versus having nothing means lots of people get to live. The Republican Plan is Go Home and Die. Sure it could be better, lots better, but don't cut off your nose to spite your face. Just elect more Democrats and it will get better. In particular the gap between the bottom income for ACA and the upper income for Medicare in some states is totally insane. Only the working poor have to Go Home and Die!
It would have made far more sense to completely replace Medicaid with an ACA that reaches all the way to zero income, with the poorest people exempt from copays and deductibles. Instead we have the two systems (ACA and Medicaid) that interface very badly.