I don't think it's accurate to say premium increases were a direct result of the ACA. I was in the private market for health insurance long before the ACA was designed, let alone signed into law. Dramatic rate increases had been the norm in the private market for many years prior. My belief is that those types of changes just took longer to reach the the group markets and would have happened regardless at some point.
If various state governors and other powers-that-be had made an effort to make the ACA work vs. blocking it altogether (by not setting up state exchanges, for example), there's a chance that premiums might have stabilized. In fact, there's been some evidence that, in some places where successful exchanges *were* set up, that has already begun to happen.
The elephant in the room that no one talks about when it comes to health care costs is that there's just more 'care' available every year as medicine advances. There's lots more that can be said on that topic (e.g. over-testing, etc.), but maybe another day...
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