One of the big differences between Obama and Clinton in the primaries was that Clinton was in favor of an individual mandate, and Obama was not. We still ended up with an individual mandate, which is both offensive on grounds that the government is forcing you to find and pay for insurance (not always easy on the exchange), and on the grounds that the primary purpose of the mandate is to ensure that insurance companies stay profitable.
Former Al Gore running mate and future republican Joe Lieberman is often given credit for stopping the nationwide insurance exchange in favor of state-level exchanges, again tipping the market in favor of insurers.
Ending denials for pre-existing conditions was nice, as were a few of the other details, but it felt like a far cry from the hope and change voters were promised. Mostly it exposed more-of-the-same pandering to the rich and powerful. Last I checked Medicare For All polls quite favorably.