The Affordable Care Act appears to be far more sustainable than the status quo ante, a patchwork of good, poor, and useless private insurance programs paid for by individuals, by employers, or in the case of fifty million uninsured, by no one. Before ACA, insurance premiums had risen for decades by high single digits or double digits annually; the ACA reduced those increases by 75% or so, until 2016 which, as Dr. Krugman points out, was an unique one-time adjustment needed because healthy people weren't enrolling. Single payer is probably the only fix for that situation. But Republicans, who run Congress, don't want single payer.

Krugman is also probably right that people  so inclined will blame Democrats for their soon-to-come loss of health insurance and health care. The reason? Many people will prefer a false narrative that confirms their worldview to the unpleasant truth that they were hoodwinked, played for the fools they most certainly are.