Is the U.S. health care system as a whole better than before the ACA in your view?

No. I'd mostly prefer market-oriented reforms for healthcare (plus vouchers), but right now we tend to get the worst of both worlds. Single payer would also probably be better than what we have now.

Also, could Obama have gotten anything more liberal—like universal coverage—through congress?

The main obstacle wasn't really that it was too liberal. Opposition from the insurance lobby is what killed "Hillarycare" back in 93 even though Democrats had huge majorities then as well. Once the insurance lobby got the "public option" removed from the legislation, they supported it.

What are your politics?

Mostly paleoconservative, less opposed to "big government" than most paleocons.