text: Health insurance premiums were growing at an un-affordable and unsustainable rate well before the ACA.   Although the ACA has added to the expense for sure, you can't say that we had affordable health care coverage before the ACA but now we don't because, even without the ACA, premiums would have likely risen to close to what they are now.    The problem is not the lack of affordable insurance.  Insurance will never be affordable so long as it's a for profit enterprise trying to pay the expenses of another for profit enterprise that sells services that are necessary but without sufficient cost controls.