" Danforth, wasn't it called "Naional Health Care" or something like that?"
No. M4A got taken out of the options early on in ACA planning.
" It got replaced by Obamacare."
Incorrect. Before the ACA it was the Wild West. The decade before the ACA, inflation was 31% over the ten years. Medical inflation, however, was up 131%, more than four times as much.
The year before O'Care started, my bride's best friend had just beaten breast cancer, and her husband had to leave his corporate job (and good health insurance) to take care of her. The only health insurance they could find was in a high risk pool ... $5000 a month, when the normal going rate was $500 a month.
One of the real reasons for the ACA was the baby boomers were about to be herded into high-risk pools, due to a relatively new low bar: pre-existing conditions.
"It would be possible to print to PDF and make all the ballots you wanted I suspect."
And each of those ballots would have the same unique serial number, and the same hidden watermark in the .pdf.
Any match gets investigated. You realize that, don't you?