The Affordable Care Act is failing the middle class because it has done nothing to address the root of the issue: costs are out of control. Instead, the ACA just spreads the same outrageous prices around and allows the inflation to continue unabated.
Consider a medical procedure like having a baby. The cost of a routine vaginal delivery can exceed $20,000 in San Fransisco this year (and a C-section is twice that). The same service in other developed countries costs half or less. This is the problem that we desperately need to fix. The cost increases are unsustainable no matter how we try to pay for them.
Premiums have skyrocketed because people are using more health care - but we haven't brought the costs down at all.