Although popularly sold as a means of reducing overall health-care costs, the creators of the ACA knew that the inclusion of such provisions as the mandatory coverage of pre-existing conditions and the setting of premiums based on average costs rather than actuarial costs would necessarily increase the total cost of such coverage.
Moreover, the Exchange subsidies available to those with incomes between 100 and 138 percent of poverty would limit their insurance premiums to 2 percent of their income and would limit their liability for cost sharing to 6 percent of the actuarial value of the plan.