Well, I hate to play the "race card" but that's mostly what healthcare comes down to in America.
Certain segments of voters don't want their tax money paying for the "wrong" people to get healthcare. And I don't mean obese people.
If America was more racially homogeneous we'd probably already have single payer.
That's exactly what it is. To be totally real, Republicans hated the New Deal from it's inception. The rich of this country doesn't even want their money to go to poor ass whites. The only reason they have been able to chip away at it is because of the Civil Rights Act. Because then they could say to all of those whites that blacks were now going to take their shyt.