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It's great that people can get coverage. It is a huge benefit for people who couldn't get coverage in the past due to pre existing conditions or low family income. But it is getting to be too expensive for people who are using the exchange and don't qualify for subsidies.

I had a long conversation last night with a friend who is in this situation. The monthly premium for he and his wife for a high deductible plan is over $1400.00 per month; almost a 50 percent increase from last year. They don't qualify for subsidies, but this is a huge problem for them.

Too many young, healthy people are skipping coverage and just paying the penalty because the penalty is cheaper than the premiums. The mandate is mostly toothless and that is going to destroy the exchanges. It is simple economics.

It needs to be fixed, and pretty soon. Congress is not going to do it. We would need democratic majorities in both houses and that seems unlikely. There are going to be more and more people who don't qualify for subsidies who are not going to be able to afford coverage. The ACA is undeniably heading for a crisis.

I'm lucky that I have employer coverage that I pay only 20 percent of the premium for. It still costs a lot, but it is good coverage and I can afford it. But if things don't change I will need to continue working until age 73 in order to keep that coverage for my family. There is no way we could afford to pay the premiums on the exchanges right now.