>>Can you name any significant achievements by this administration to improve ACA? (Note: anything beyond "kicking cans down the road" regarding delays in implementations)

What does that have to do with selection of the least terrible POTUS?

Partisan politics has people piling up lists of current grievances. That makes for a great moan-fest but it's a big "so what" when in a few days the US voters must select their new POTUS. One of the undesirables advocates improving ACA, the other promises to repeal it. If the US goes back to the pre-ACA status quo, the US is sprinting towards a healthcare funding crisis that will cause almost universal public revolutionary mindset and ridiculous unimaginable cost to resolve. Meanwhile Trump's "drain the swamp" actually would do the US a great service, but he's a political neophyte and has been such a jerk handing gifts to enemies who proclaim 20-year-old filthy bragging to a Bush scion as if it's an admission of guilt yesterday, while giving Clinton a free pass because naughty stuff was a long time ago and because, well, "Russia." Clinton also has the mighty hidden hand of entrenched power and privilege behind her, while Trump is a breakaway "Dennis the Menace" larrikin with infinite imaginative ability to come up with new ideas to give everybody a turn at being shocked. Whether he ever actually acts on such ideas or can be prevailed upon to count to 10 before blurting them out, is an interesting thought.

Anyway, if planning involves hoping for the best but preparing for the worst- then what is the worst you can expect of these two and who is the least bad? Piles of grievances about current politicians doesn't actually help.