When it comes to Obamacare, what we don’t know is as as important as what we do. Megan McArdle points out four key areas in which the future is still undecided. One is premium costs. So far, premiums haven’t risen nationally as much as some of the law’s critics predicted—though certain areas have seen big average increases. But McArdle points out that insurers are in flux; those who underestimated their payouts will have to raise prices. Second, they are also waiting to see how consumers behave in the marketplace, particularly whether they shop around or stick with the same plan year-on-year no matter how premiums fluctuate (in which case they will be more likely to raise prices):
All of this adds up to the possibility that prices will begin to rise steeply in 2016 or 2017, as the risk-sharing programs expire and the markets begin to shake out. Most consumers will initially be insulated from those cost increases by the subsidies, but starting sometime after 2018, there’s a subsidy cap that will kick in if prices grow too quickly, meaning that consumers could ultimately see some of those price increases.
McArdle also discusses the fate of the individual mandate and the pending court decision in King v. Burwell, which would throw the law into utter chaos if the Court rules against federal subsides. She argues that the likelihood of serious changes to the law depends on how these four factors play out.Two other areas that are crucial to watch are state-level Medicaid expansions and the bipartisan hostility to the employer mandate (which she briefly mentions). Meanwhile one big question is how far factors outside the ACA’s nexus of issues—such as new technologies and price data releases—will reshape U.S. health care on the ground. With all this uncertainty, it would be foolish to make definite pronouncements one way or the other about how the law will play out. Read the whole thing.