Certainly, no small feat.  Prior to ACA, most Americans did not realize how vulnerable they were to loss  of health insurance or to crippling restrictions that may have been inflicted upon them.  

It was not just a lack of money that caused many to be uninsured, it was a lack of access--being denied because they were too sick or had pre-existing conditions.   And, the bulk of the insured who received coverage through their employers were finding, with the rise in health costs, that the policies provided were much less valuable, higher deductibles and co-payments.  While some pine for the good old policies, more likely than not, they did not know what coverage they really had. Often, as with any insurance you don't know how good it is until you need it.

While ACA appears to be impacting costs, the "bending of the curve" is likely a mix of the deep recession as well as cost reductions anticipated or implemented by ACA (e.g., targets to induce hospital efficiencies and economies, incentives/disincentives for re-admissions, computerized records, and preventative services.)    

But, in my view, the basic issue is that health care, itself, is increasingly, unaffordable.  Shifting costs is just that, a shift from the government or insurer to the consumer.  But the costs remain.  It is the nature of progress in health care--new technologies and new drugs to treat the previously untreatable are expensive.

For example, the drug, Sovaldi, to treat Hepatitis C, costs $1000 per tablet; requiring, typically, 84 doses ($84,000).  Similarly,  less than 10 years ago, an illness such as myeloid leukemia had a bleak prognosis; today it can be managed so that patients can expect to die of old age.  But, at a cost that is prohibitive for almost all without insurance coverage.

Insurance premiums reflect what's known as "medical trend"--a metric that combines the growth in the cost of health care services with the rate at which people use those services. Health care spending has been growing at record lows for the past few years, and while the White House has claimed that Obamacare deserves at least some of the credit, the broader economic climate is also a big part of the reason. The Kaiser Family Foundation has found that health care spending rises and falls with the economy, but lags a few years behind. That means the economic recovery might be about to show up in health care--and make premiums more expensive.

"Based on our model, right about now is when you'd expect the improvements in the economy to start putting pressure on health care costs," Levitt explains. He says medical trend will probably pick up by 5 percent or 6 percent next year.

On top of that, one of the health care law's safety-net programs for insurers begins to scale down next year. The law pumped $10 billion in reinsurance payments into the market this year, to help offset the risk insurers shouldered by entering a new and unknown market. Those payments scale down to $6 billion in 2015. According to Levitt, that could add another 3 or 4 percentage points to premiums, on top of medical costs. "You could get pretty close to 10 percent just by those two factors alone," he says.

Other analysts agree it will average out to increases of 6% per year from now until 2016.

For example - Florida:

Most of the consumers who bought a private health plan from Florida Blue through the Affordable Care Act's insurance exchanges between October and April were previously uninsured -- one of many factors potentially leading to higher premium rates in 2015, according to a senior executive.

Jason Altmire, a former Pennsylvania congressman and now senior vice president of public policy for Florida Blue, cited familiar reasons for a likely rise in rates next year, including the requirement that insurers no longer exclude those with pre-existing conditions, charge equal rates regardless of gender and charge older members no more than three times the amount paid by younger ones.

Other reasons consumers may see higher premiums in 2015, he said, include the Obama administration's decision to allow Americans to keep their health insurance plans for an additional year even if the plans did not meet the coverage requirements of the health law. Altmire said that most consumers signed up through the exchange were previously uninsured Americans who may have delayed seeking medical care, making them potentially more costly to insure."A lot of them aren't in the best of health," he said, noting that consumers who signed up at the outset of open enrollment were likely the ones who needed it most. "We expect it to cost more to insure them because of deferred health needs."

But even the CBO is hedging its bets:

The CBO cautioned that healthcare premiums are difficult to predict and said premiums in some parts of the country could be much higher or lower than its projection for 2015.

All that is certain is it will cost more then they said it would.

To anyone who'd claim this was a success I'd ask by what measure?   What's the new goal?   Because the original one of insuring the uninsured doesn't even seem relevant anymore.

It seems to me the proponents of this law consistently move the goal post so that any type of success can be claimed.

Anybody want a puppy?!

*photo is from Sat or Sun before her legs sprouted some more.

"I want to tell you one more thing I know about the Negr@," the rancher began as he described a "government house" in Las Vegas where he recalled that all the people who sat outside seemed to "have nothing to do."

"And because they were basically on government subsidy, so now what do they do?" he said, as quoted by the Times. "They abort their young children, they put their young men in jail, because they never learned how to pick cotton. And I've often wondered, are they better off as slaves, picking cotton and having a family life and doing things, or are they better off under government subsidy? They didn't get no more freedom. They got less freedom."

The embarrassment is not over. Texas Governor Rick Perry defended Bundy and his militia pals just yesterday on Fox News, complaining that the Obama administration "acted imperialistically" by trying to remove Bundy's trespass cattle. Nevada's Governor Brian Sandoval also gave Bundy a measure of legitimacy by criticizing the BLM. The Koch brothers-backed Americans For Prosperity's Colorado and Nevada chapters have endorsed Bundy's range war, which is still attracting so-called `Patriot' militia participation from Western states. Now that Bundy has let us all know what he really thinks about the world outside his ranch, how long will their support continue?

But this map does succinctly portray dramatic variation across the country in housing costs, and it suggests that proposals to modestly raise the minimum wage won't fully solve this problem.

??

A Warren/? ticket might get me to pull a Brand D lever for the first time in 12 years...Warren is appealing enough a candidate for me to look past her poor choice in party association. I could even look past Clinton as her VP choice.

Are you rooting for the ACA to fail? Because sometimes, the apparent giddiness you convey whenever you post bad news about it -- e.g., both bolding and capitalizing the aforementioned term "EPIC FAIL" -- sure makes it look as though you are. And then, you wonder why BTD and others believe you to be a closet Republican.

Suffice to say that the Affordable Care Act of 2010 is not the end game in and of itself, but rather a necessary first step in what will surely be quite a many more in a long and winding road, as the reform efforts in the delivery of health care take firm root in the public consciousness.

It took this country decades to create the current Rube Goldberg contraption that's called 21st century health care in these United States, and its vested interests are such that any attempts to reassemble it as a more publicly responsive system are going to take a lot of time, effort and perseverance in order to succeed.