They are all against it because Big Pharma spends so much money on lobbyists.
Remember the first thing that was done when ACA was being written? The President brought in the heads of the big pharmaceutical companies and told them that it would be business as usual for them. That was one of the first reports about what was happening in 2009 when it was being written.
It was difficult to know exactly what was going on because even though President Obama promised that the health care bill would be written while being televised LIVE on CSPAN so there would be total transparency to the American people...that turned out to be just another lie told on the campaign trail.
And we ended up with Pelosi pressuring the Democrats to vote for it first and THEN read it.
Hardly a case of the President "appeasing Republicans". Since no Republicans or Dems had even READ the damn thing before it was passed on a party-line vote.
In other words...no Republicans voted for it.
So there was no "appeasement" by Obama.
Google it up. Look at the news from that time period. It's not hard to find.