You're kidding, right?

First of all, the Affordable Care Act was mostly just cheating off of Mitt Romney's paper.

Second, Federal legislation in general is ghostwritten by lobbyists most of the time to begin with.

Third, of course they have manpower: they control their own budget and can vote themselves as much help as they want. If they choose not to do that, it's hardly an excuse for failing to get shit done!

Fourth, even if the above weren't true and they really did have to choose between the ACA and the other things mentioned upthread, prioritizing further enshrining insurance industry bureaucracy in its privileged position was absolutely the wrong choice.