I read often that the Affordable Care Act passed by the Democrats and signed by Obama will save money on health care costs. Since most people get confused between healthcare and health insurance I will not comment on the difference. Suffice to say, what we are talking about is health "Insurance". While many of us don't have health insurance, we still can get health care and do. And we pay for it contrary to the ACA advocates who say that the rest of the rate payers subsidize those without insurance but I digress,
Health insurance is a mechanism by which we defer health care costs to a third party, usually the insurance company but also defer some of the costs to our employers as a form of compensation. Insurance premiums reflect the risk of paying claims and are subject to the demographics of the population insured. In addition, state mandates on what should be covered and what has to be covered as well as deductibles, co-pays etc drive the premium costs. All things being equal a given group's premiums should exactly offset their claims plus administrative costs plus profit. Here is where it gets dicey. If an employee has a major claim ie heart surgery, then the group's premium has to increase to cover the loss. There is no free lunch. Increasing state mandates for coverage have increased premiums across the country and the Affordable Care Act is no exception.
The following parts of the ACA will increase premiums:
1) Keeping adult children on parent's plan. This increases premiums because you are now insuring more people.
2) No pre-existing conditions. This will increase premiums because insurance companies will no longer be able to avoid those risks.
3) No lifetime caps. Premiums have to cover actual costs. If you cannot cap the loss you have to increase premiums.
4) Guaranteed issue. With no way to avoid losses from possible negative selection premiums have to increase.
If insurance companies were allowed to construct policies that could avoid the mandates and find creative ways to insure more people, overall premiums would come down as more people would be insured spreading the risk over more premium payers. As long as the government dictates the coverages and the limits to flexibilty then insurance premiums will continue to escalate.