They are actively sabotaging the Affordable Care Act, and so far pretty successfully. After all, when Rs in Congress prevent funding for the federal website, little wonder that it's screwed up. Notes Kevin Drum:
No federal program that I can remember faced quite the implacable hostility during its implementation that Obamacare has faced. This excuses neither the Obama administration's poor decisions nor its timidity in the face of Republican attacks, but it certainly puts them in the proper perspective.
They aren't the only ones--our old friends the insurance companies that largely caused an expensive dysfunctional system with no conscience even when it comes to killing people--they are doing their best as well. As are certain elements in the media. And while I might myself be more upset by apparent problems in the individual coverage market if I were still in it, this article notes that the very small group affected is likely more educated and affluent, while the Act is already helping the overwhelming number of low income families.
Still, the main saboteurs are Rs in Congress who've done more than hold empty votes defunding the Act--they've made implementing the Act and publicizing the system devilishly more difficult, and in the states that started this all by placing an unexpectedly heavy burden on the federal exchange.
And that, with historical context, is the topic of Bill Moyers' commentary above.