PPACA is too complicated. But the reason is because of the Obama administration attempted to accommodate the private health insurance market. Private insurance companies would get 30 million new customers with a check in hand. The dream of every business. Reform would have been much simpler if PPACA would have just been Medicare For All.
Will the private insurance companies thank and appreciate that effort? Of course not. They campaigned and will campaign against Obama and democrats.
Instead of proposing real progressive ideas that work, Obama wanted to appease the right and got what he bargained for: wasted his political capital and runs the risk of getting his bill nullified by an activist and political SCOTUS.
Lesson for next time. When you have the power use it to push real liberal solutions, not watered down version designed to appease, that at the end do not solve the problem and do it appease.