Bob Kocher and Ezekiel Emanuel, who worked in the Obama White House on health care reform, argue that it’s “misleading” to raise concerns about the fact that individual market health insurance premiums have nearly doubled under Obamacare. “Premiums today,” they say, “are 20% lower than the Congressional Budget Office predicted when the ACA was passed.” Their argument is nonsensically out of touch, and it illustrates why the designers of the ACA got so many things wrong. The unaffordability of exchange-based insurance is the ACA’s most serious problem. As research from Avalere Health has shown, enrollment in ACA-based insurance is alarmingly low among those whose incomes exceed 200% of the federal poverty level.

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