When two parties run on a single issue in the general election and one party wins the most votes in the presidential, senate, and house elections…you know the people have spoken on the issue. It was true in 2004 about the Iraq War, it was true in 2012 for universal health care (disclaimer: Democrats won the popular vote in the Senate in 2004 and the House in 2012 without winning majority of the seats in either chamber). Opposition to that war was as passionate as the opposition to the affordable care act. But in a constitutional democracy, the only thing that matters is the ballot box, not the decibel level of the opposition. The people supported the Bush Doctrine of spreading democracy and rising military power, just like the people supported the candidate campaigning on universal health care for two elections in a row. The people turned against the GOP in 2008 because of mismanagement of the mandate in 2004, just like the people will turn against the Democrats in 2016 if the ACA is disastrous. But the point of a presidential or a parliamentary form of government is that a candidate or a party campaigns on an issue, and is allowed to implement those policies if elected and given a chance to let it work. If a party, person, or a faction cannot accept that and holds a nation hostage, then the precedent set will be the end of representative democracy.