"It is a rhetorical question....I didn't want to insult folks intelligence by stating as much."  Comrade Sanders

I believe your intent was clear.  You don't believe that the ACA pays for itself.    Rhetorical means a question that nots looking for an answer but making a point.  You said it's was only a rhetorical question, not another reader.

Nothing wrong with the question by the way.  Congress does a lousy job of setting metrics to judge performance of their legislation.   

Why do you believe that the ACA has not improved the healthcare of participants?