The hurdle was always the access point. Medicare is great...but you have to be 65. Medicaid is good...but you had to be poor. The Medicaid expansion blew a hole in that by making more people qualify for it, and also increasing reimbursement rates for doctors so they participate. The infrastructure is in place to keep upping the income limit, and to later get rid of it. Medicaid for child and adults, Medicare for elderly.
I'm all familiar with Democratic campaign slogans and promises regarding this issue. The fact is that a true legitimate expansion should have been sought from the start, not negotiated off the table in private in negotiations with private insurance companies.
It's not going to happen overnight. I think people aren't peeping the genius of killing the negative perception Medicaid has always had as "poor people healthcare." It's helping the working class now, and will be expanded even more.

People were asking for Medicaid expansion for decades. None of it has happened on anywhere near a scale that benefits most of the working class in this country. You know, the labor that funds the pockets of the government, makes the rich richer, and helps subsidized the poor. Much like education, they are the ones being royally fukked here.
The other big thing the ACA set the stage for is killing employer insurance, which is a good thing. You shouldn't be fukked over if you lose your job because your healthcare is tied to it.
"Setting the stage", "paving the path", blah blah. These are not absolutes. Like I previously mentioned, the country heard these same things 50 years ago. The Democratic Party on a Federal Level has shown time and time again that they are slave to corporate interests and this gives you faith that they will fight to make social progress on their own big business bill? I don't even know what to say to that line of thinking.