If you’re trying to figure out what’s going on regarding claims that Obamacare costs are spiraling out of control, I recommend this piece by Jonathan Chait of New York magazine. Chait really understands this stuff. The key takeaways:

  • The premiums announced for next year are about what had been predicted when the Affordable Care Act first went into effect. The reason the jump is so high now is that insurance companies initially underpriced their policies in order to get more people to sign up. And the premiums are still lower than they would have been without the ACA.
  • There are 50 insurance exchanges—one in each state. They are working well in states that supported the law and accepted federal assistance to expand Medicaid, and not well at all in  states that didn’t. So it’s ongoing Republican resistance to the law, not the law itself, that is the source of some of the problems.
  • Complex legislation like the ACA often need fixes every now and again because there’s no way officials can predict with absolute certainty what’s going to happen. Unfortunately the ACA can’t be amended or fixed in the current political environment because the Republicans in Congress won’t allow it.

And thanks to Jonathan Cohn, a health-care expert in his own right, for flagging Chait’s article.