Well there are alternatives besides the PPACA and doing nothing. For years, conservatives have advocated ideas, which they thought would lead to improvements in our health care system. For example, health insurance costs are tax deductible only if your employer pays. Why should your health insurance be tied to your employment? Why shouldn’t an individual be able to deduct health insurance costs from their taxes just like an employer does? Why shouldn’t individuals be able get a better price for their health insurance by bargaining as a group (they can’t under current law)? Why shouldn’t individuals be able to purchase health insurance plans across state lines (they can’t under current law)? Conservatives believe that such reforms would foster more competition, which would lead to cheaper and/or better health care (just like competition leads to a new and better smart phone every six months).
In general, conservatives are wary of one-size-fits-all, centrally planned solutions. They prefer giving individuals the freedom to choose their own solutions. What’s more, the above reform ideas wouldn’t cost anything. Why have progressives (and moderates) always been against them? I could get into the theories as to why, but I won’t (books have been written on the subject).
As to fairness, Medicaid, is supposed to provide health care to those who can’t afford it. However, this centrally planned solution has become a key factor currently driving many states to bankruptcy. Why not try to fix Medicaid before you try fixing the entire health care industry?
