It goes even farther back the Massachusetts health care law was originally a Republican plan dating back to Richard Nixon. The Republican had been holding it in their back pocket for decades planning to implement it as a compromise when the Democrats tried to push for real socialized medicine. Instead the Democrats put it in place undercutting the Republican as they had nothing to push in its place. that's they it has survived despite the Republican holding congress and the white house for several years they just didn't have anything to replace it with.