for the small subset who are getting increases. Most won't since SS didn't get a COLA and thus by law those Medicare recipients won't be getting any increase in premium but those who do (new enrollees and certain wealthier seniors) will see an increase of about 50 percent.

Never thought this would happen.

Granted, various reasons were proposed.

Competition and getting into the market led to unrealistically low rates. Once the market stabilized and market shares could be considered "locked in", they'd rise to cover costs.

Nobody knew the mix in the insurance pool. Predictions made by proponents tended to be rosy. Those made by opponents were grim. Reality's usually in between.

Once people had insurance, many more would be using services than had been. More services = more expense = higher outlays.

Moreover, if the Massachusetts experience turned out accurate, costs would rise disproportionately faster than expected. People would use more services, but they wouldn't change another habit: Once you're habituated to emergency rooms substituting for the family doctor, you continue to use the emergency room even if a GP is cheaper. Until you've been punished for misusing the system.


The response was that increases were subject to approval by not-entirely independent boards. On the other hand, if administrative expenses are capped and increases are to match costs, you'd expect requested increases that were in line with the administrative/actual cost breakdown and plausibly reflected actual, real expenses to be rubber stamped. Because the requirements for approval were clear and could easily be met--leaving those doing the approving less discretion when insurers follow the rules. Many people think laws only apply to the unrighteous. The penalties do, to be sure, because the righteous already follow the laws.

thus guaranteeing that healthier people would just pay the (small) penalty instead of paying
for insurance that subsidized sicker people.

Also despite what many people think the ACA didn't really include provisions to ensure significant
reductions in the cost of care.