“As the rates rise, the healthier people pull out because the out-of-pocket costs aren’t worth it,” Bertolini said at Bloomberg’s The Year Ahead Summit in New York. “Young people can do the math. Gas for the car, beer on Fridays and Saturdays, health insurance.”

Premiums for health plans sold to individuals under the ACA, known as Obamacare, are going up by about 25 percent on average for next year. Bertolini said that as costs rise, more individuals will decide not to buy health plans. That’ll push premiums even higher, unless a new president and lawmakers can find fixes for the new markets created by the 2010 health law.

“What happens is the population gets sicker and sicker and sicker and sicker,” Bertolini said. “The rates keep rising to try and catch it. It’s a fruitless chase, and ultimately you end up with a very bad pool of risk.”

The government has emphasized that subsidies are available for many people to help cushion the premium increases. When they are taken into account, about 77 percent of current ACA enrollees will be able to buy health insurance for $100 or less a month, the U.S. said in a report on Monday.

Eoin Treacy's view

When I got my renewal for insurance from Covered California, the local health insurance marketplace, the premium had risen 29% over last year. The only reason it wasn’t higher is because they also raised the deductible and offered less coverage. That’s for a family of four who are healthy, have no allergies, take no medications and exercise regularly. I just did the math and I would be nearly $4000 better off if my family did not have health insurance and opted instead to pay the fine. I’ll buy insurance because I see the value in having cover but it’s not a no-brainer decision.   

For young people, making a decision about whether to pay the fine or buy insurance, the important cut off is $28,700 in income. Above that level the $625 fine becomes 2.5% of income. By some measures around 50% of Americans earn less than $30000.so every dollar counts and it is often cheaper to simply go without health insurance and the fine is just another tax. Personally, I’m rather surprised that the rising cost of healthcare, particularly for the middle classes who are not eligible for government handouts, is not a bigger election issue. 

UnitedHealth which was one of the first groups to quit the health exchanges has fared better than others that continue to offer plans under the Affordable Care Act. The share remains in a broadly consistent uptrend. 

Meanwhile Anthem is one of a number of shares in the sector which needs to continue to demonstrate support near current levels if potential for higher to lateral ranging is to remain even remotely credible. 

The cost of healthcare is a major factor in wage inflation because if people are either paying more tax or shelling out more for premiums that’s less money for everything else. It’s one more reason for expecting inflationary pressures to build.