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The ACA was an attempt to make the current health system a little better. Sure Biden promotes it, but that doesn't mean he's championing the health system overall. You probably already know that the ACA was originally based on a Republican health plan. Obama went with this rather than Medicare-for-all because he thought it was the only way he could get Republican buy-in to pass any kind of health improvements for citizens. But even so the Republicans demanded all kinds of concessions and watered it down so it ended up being way less effective than intended. The bottom line here? Health care affordability problems are because Republicans don't want to fix them.
Also let’s not forget such hits as Bill Clinton attempting a border healthcare reform which died very promptly. Which is why Obama and his advisors chose the republican approach.
Also let’s not ignore that ACA originally had the public option in it. But as always, there is always enough money in bribes to turn just the right amount of Democrats against core wins so that it was a Democrat (I forget the twat’s name) that demanded the public option be stripped from the bill.
With such a great plan from a party known for lifting a sausage-like finger for the poors, ever, I can see why every republican has given it unanimous and resounding support every day since it was (re-)proposed.