Political discussion aside, The Affordable Care Act will fail for business reasons. The fundamental reason the ACA will fail is because it mandates a minimum Medical Loss Ratio (MLR), or the percentage of premiums paid out to cover health care expenses. The problems associated with mandating MLR are two-fold: 1) incentivizing the insurance industry to become less efficient; 2) contributing to the elimination of new insurers entering the market and increasing the level of competition.