Andrew Sullivan notes Ezra Klein's endless crusade to remind everyone that the Affordable Care Act was based on Republican proposals:
Democrats have been willing to adopt Republican ideas if doing so meant covering everybody (or nearly everybody), while Republicans were willing to abandon Republican ideas if sticking by them meant compromising with the Democrats. But because Democrats were insistent on getting something that would help the uninsured, they've ended up looking like the partisans, as they keep pushing bills Republicans refuse to sign onto.
Sullivan says this contributes to the "Big Lie" of Obama's alleged "extremism," but this is how partisanship works. and why the left has been so irritated with the White House's preemptive concessions, because they knew the GOP would continue to shift the goalposts right. The reality is that the "center" is not an ideological place but a political one, defined not by the nature of a specific policy but the political positioning of the right and left poles of debate. The reason why Democrats didn't produce a more liberal bill is because the coalition of preening centrists needed to move right every five minutes in order to locate themselves in the "middle" between a GOP sprinting to the right and a left willing to take major steps in the same direction. Moderate as policy, there was no way for the ACA to be "centrist" in the sense that the Village understands it, because Republicans were never, under any conditions, willing to consider voting for the bill.
But that's how Republicans win the game, because they're essentially playing with a different set of rules: Democrats have to cooperate, Republicans don't. And there's no political cost for the GOP because they understand that voters care about results more than anything else. It's just pure political self-interest.