I refer to it as "the ACA", which is short and avoids an unofficial moniker first introduced as an insult.
It's not just a personal preference, it's civically important: There are still morons out there who have spent the last 15 years simultaneously gushing about how the ACA is awesome while demonizing "Obamacare."
That said, let's call it what it is... it's a war machine. Just as we should refer to Israeli Occupation Forces and not "Defense" forces, since genocidal occupation is just about the furthest thing from defense.
It’s not a war machine, it’s a pork processing system for Congress.