Naturally there is some tension between the two "missions" of the ACA: 1) decrease the number of uninsured/uncovered people, and 2) decrease or curb the increasing cost of healthcare. It is unequivocal that the ACA has achieved results under #1. The real question is whether it has had any impact on #2. I don't know the answer, and I'm curious if anyone has come across any research looking into this. The easy answer is to point to premium increases and say "no way", but we have to remember that before the ACA, medical care expenditures came from a variety of sources. You were not only paying for your own care through (lower) premiums, copays, etc., but you were in part paying for the uninsured through federal, state, and local taxes, charity, etc. So it is entirely possible that the average person is in total spending less, or at least seeing curbed increases, now than before, even if the explicit premiums/deductibles/copays have actually increased. But we don't know that, it would take some serious research and analysis.