What exactly was intended to be covered by the ACA? That was clearly undefined at the time of passage. The only answer available was that a panel would be convened on a given topic and a decision made, approved by the HHS Director.
The general consensus was health care is a 'right' to be expected by American citizens (and even non-citizens, but that's a different argument.) If it's a 'right', then what exactly constitutes that 'right'? It simply was not defined and few seemed to have any problem with that very concerning fact.
For example, did the ACA intend to cover vision insurance? Did it intend to cover Dental insurance? What about variants like orthodontics? What about dermatology? What about cosmetic surgery?
It's a bold question, but a simple one - is it truly a 'right' of all Americans of all ages to expect to have straight white teeth, perfect vision, clean skin, and an erection on demand? (Viagra is covered.) Should we throw in Blond Hair and Big Boobs as well? It's not a very long stretch from there to start discussions on what happens if you DON'T have these positive attributes... it will be completely up to HHS Director. Of course, it won't reach that extreme stage right away. The first step in that direction will be HHS Director deciding on life/death of the unborn that is diagnosed with some incurable, debilitating disease. Surely it will be in the best interest of all not to introduce those into society, right? How long until that particular discussion on the unborn is had by the HHS Director? Has it already been had? Does anyone know? Does anyone doubt that it will be had at one point in the future?
Few seemed concerned to what was covered, just that some coverage was available, whatever that means. Coverage was/is to be determined at a later time by one single person with full power to decide on what is within your rights. One single person deciding your rights ... does that seem like a good idea in general? Perhaps with the do-no-wrong in power today, but what happens if another do-no-right gets in power next time?
As Nancy Pelosi said, "we have to pass the bill so that you can find out what is in it – away from the fog of the controversy." These questions weren't answered ahead of time - they were intended to be answered later. So this 'right' was general in nature and everyone got together and decided to grant this 'right' in concept and determine later what it actually included... and it actually passed because the general nature of the ACA is good in theory but actually horrible in practice.