As chaos grows, it will be tempting for these Republicans to claim that they and the broader right bear no culpability. Obama and Obamacare did this to them. But that message won’t wash outside of precincts where antipathy to the president already runs extremely deep. Elsewhere it’ll be drowned out by a simple but forceful argument, promulgated by people with much larger megaphones—and by the fact that everything was basically OK until five Republican-appointed Supreme Court justices intervened. Unlike Republicans, the team of organizers, lawyers, and political operatives who have banded together to save the ACA have adopted a strategy that precludes them from discussing their political contingency planning. But it stands to reason that Obama and Clinton would both lay the damage at the feet of those justices, and the party on whose behalf they had acted. The ruling would create a hydra of loyal but politically disengaged Obama supporters, consumer groups, health care providers, and other actors, none of whom will be satisfied with Republican excuse-making and inaction.
As they say, all politics are local. It's funny how many republicans I meet work in sectors that would be eliminated if the party they claim to be a member of were to have their way. For example, last night I had lunch with a women that works for a large cities housing authority. Basically, they provide or manage rental properties for the poor. The tenant is mandated to pay 30% of their income for rent and the government pays the rest. This program wouldn't exist in a republican controlled world, yet she's a republican. So odd.
Anyways, All politics are local and as the ACA gets better at signing people up and better at communicating their effectiveness via testimonials etc from those that have used it, it is possible that it will be harder and harder for politicians at the state level to get rid of it. Even in red states. It's possible, but then again as I mentioned above, people have a weird way of biting the hand that feeds them.