You mean besides introduce economies of scale and lower prices? Other than that?

The ACA isn’t any good. The only reason democrats claim to like it is because it has Obama’s name on it.

These seem reasonable objections:
Selling Health Insurance across State Lines Harms Consumers
advocacy.consumerreports.org - Sale Across State Lines FINAL

Did the last Republican proposal include selling across state lines? I can't remember. I can't find their latest proposal. Think they gave up on it.

...........

I'm self-employed. I like the ACA simply because it allows me to buy health insurance for my family.

Without tax subsidies ours is expensive, has high deductibles, and a very narrow network. I'm all for an improved system, but it must have guaranteed issue and essential health benefits. You know, just like employer plans have. Prior to the ACA it was a nightmare for those of us buying our own insurance.

For our family of 5 in 2023:
Premiums $21k (small subsidy)
Out of pocket $15k

The premiums are an above the line deduction. Out of pocket wasn't enough for a deduction.