Those on both the left and the right overestimated the effect Obamacare would have on the larger health care system. The footprint of Obamacare has been smaller than expected. It hasn’t shaken up the employer system all that much, and it hasn’t changed the underlying health system as champions and critics thought it would. It hasn’t reduced the uninsured as much as expected and (therefore) hasn’t cost as much as expected overall even though per capita costs are higher than projected. The exchanges have drawn far too few healthy people to be stable and the rules that govern them have had too little of an effect on the dynamics of our larger health economy to be fundamentally disruptive.
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