There’s an entire art form devoted to how referendum/public questions/ballot initiatives phrased on ballots so as to result in the exact opposite result as intended.

More than 200 years of jurisprudence in the US at the federal and state level relies on the legislative histories to help untangle what the intention of laws are meant to be as originally framed. This isn’t just some admission that drafters have purposes other than publicly stated or that the drafters are sometimes at cross purposes with each other because of constituencies they’re trying to placate.

The drafting of the PPACA was fraught with the need to get enough people on board - so they tried to frame the individual mandate as something other than a tax, even if it was based in the Internal Revenue Code (and the S.Ct. ruled it a tax in any event). There are indeed tax components to the ACA, and there are people who are ignorant of the rationales, purposes, and benefits of the ACA to all Americans from expanding access to health insurance via exchanges and the Medicaid expansion to those who don’t meet the qualifications for subsidies.

And those people are GOPers/right wingers.

Because they apparently don’t understand that a healthy workforce is a more efficient workforce, and that it can bend the health care cost curve down - by applying efficiencies of scale to get price breaks that otherwise wouldn’t be given.

And in any event, the US health costs still exceed those of other Western countries with not much to show for it in terms of higher life expectancies. We get the bill for high costs, but not the benefits.