It would have been a good start. Figure out how to get the fraud down and fix the payment / paperwork. Pilot a few different schemes and look at some of the state programs. Cutting the funding was not the most brilliant part of the bill.
If you're looking for a specific pilot program for the affordable care act, how about the Massachusetts law? It's not quite as popular as medicare, and it looks like MA residents don't think the law is perfect, but they also seem to prefer it to not having it at all[1]. I don't think anyone who is serious is saying it is a failure.
