The United States Senate is the latest—and certainly the most prestigious—body to recommend pulling the plug on the Affordable Care Act (ACA, also known as Obamacare). The Senate followed the lead of the House of Representatives by passing a new bill on December 3 that essentially repeals ACA. Passage of the new bill may be a moot point, as President Obama is likely to veto it. Once heralded by proponents as the salvation of uninsured Americans, ACA has been plagued by spiraling costs on all sides. While public health spending has declined since ACA was passed in 2010, overall healthcare spending in the US topped $3 trillion in 2014, accounting for 17.5% of the gross domestic product, according to the Centers for Medicare & Medicaid Services.

Industry experts have charged that the ACA was poorly designed from the start, leading to high consumer cost that provoked the healthiest patients to drop their plan. That left the unhealthiest plan members—those that cost payers the most—making up a greater percentage of the population covered by ACA exchanges. This vicious cycle has led to losses that run into the hundreds of millions of dollars for some insurers. UnitedHealth Group, for one, has said that it may bow out of ACA in 2017.

Dark Days for the Affordable Care Act
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