10 Questions in the U.S. Health Care Cost Debate

Has the Affordable Care Act Held Down Prices?
Hisham Uadadeh enrolls in a health insurance plan under the Affordable Care Act with the help of A. Michael Khoury at Leading Insurance Agency in Miami. Joe Raedle/Getty Images

There's no arguing that spending on health care has declined over the last decade. Is that because of the Affordable Care Act (ACA)? Experts say it's possible the act is responsible for some of America's lowered health care spending levels. But certainly not for all of it. Unfortunately, no one knows for sure [source: Kessler].

President Barack Obama signed the ACA into law on March 23, 2010. This act mandated that, with few exceptions, every American needed to purchase health insurance and the health insurance purchased had to include 10 essential benefits. Parts of the act were aimed at making health care more affordable and accessible. Two examples: Insurance companies have to prove any proposed premium increases of 10 percent or more are justified before the rates can take effect, and customers can't be turned away by insurers for pre-existing medical conditions [source: U.S. Department of Health & Human Services].

But while some of the new laws are clearly aimed at holding down prices, many aren't. (There's no cap on what hospitals can charge, for instance.) Which is why experts can't say for sure why spending levels are staying low long after the recession ended. The Henry J. Kaiser Family Foundation, for one, asserted that 77 percent of the decline in spending is due to changes in the broader economy, like lower inflation. And we don't know if the decline will last. The 3.2 percent increase in health care costs in 2015 was the lowest in 20 years, but the 2016 projection is 4.1 percent [source: Insurance Journal].