They could have done whatever it was they wanted.

They addressed healthcare and improved it. They tried to make it bi-partisan so it would continue to move forward. Republicans refused...the rest is history.

Republicans had both the house the senate and the presidency for two years. What they wanted was tax cuts for the wealthy. They got it but it was based on lies, was far from bi-partisan and will likely be repealed.

You don't get everything you want. You don't necessarily even get to keep what you manage to accomplish.

So we got the ACA. It was never good enough but it was the first thing to get any traction since Hillary Clinton tried to reform healthcare as FLOTUS. The ACA didn't require a public option because those who would buy into it were covered under the Medicaid program. It was a tidy, efficient, businesslike approach to healthcare written by Republicans.

Then they started picking it apart, like a game of Jinga, but certain aspects of it were very very popular and the damned thing refuses to fall apart. It could even be salvaged.
Good coffee, good weed, and time on my hands...