Insurance does not work unless everyone has it. Universal coverage requires universal enrollment.
So there need be no persuasion, no offering a good deal, no opting out or in , just a command from on high.
So far all the improvement is in that about 5% more are covered than used to be, it isn't universal , it isn't cheaper , it isn't better in quality.
If everyone who is paying significantly more votes Republican, there won't be much hope for Democratic candidates .