ACA's goal was to de-couple insurance from employment by having exchanges that anyone can enroll, and in theory you gain some negotiating power by participating in a plan that thousands of others have chosen.

I think one problem is perception - when you don't see the health insurance premiums on your pay stub, you tend to think of them as $0, so going from $0 a month to $800 a month does seem outrageously expensive.

The other problem is the tax treatment of health insurance premiums - they're deductible for the employer, but not deductible for an individual. One of those inconsistencies needs to change, most likely deductibility on the corporate front, as that somewhat contributes to the rise of total costs ("who cares if it's 5% more expensive this year, it's a write-off") and is a corporate subsidy - the money that could've gone to the benefit of all citizens is funneled to large corporations to help those nice fellows cover their costs of doing business.

With the ACA it isn't all that complicated, a small business doesn't have to offer health coverage, just pay enough to still have the job be interesting for people willing to buy a marketplace plan.

I also wonder if actual premiums paid by end users in the individual marketplaces (that is, prices after subsidies) are really vastly inflated compared to group plans (it's just the group plans hide a lot of the cost from the insured).

I agree that healthcare and employment should be decoupled, but it would then increase individual taxes, which is poison to Republicans. All our significant competitor nations have nationalized healthcare/insurance (NHCI). Thus, the existence of NHCI alone doesn't give us a disadvantage over such nations. You could argue that HOW we do NHCI is no good, but that's a long and thorny side discussion.