OP here. This is Part 3 of my series on US Healthcare structural flaws. The core argument is that the ACA’s 'Medical Loss Ratio' (which caps insurer profits at 15%) inadvertently created a 'Cost-Plus' incentive for inflation. Insurers bought Pharmacy Benefit Managers (PBMs) to 'launder' profits from the regulated insurance side to the unregulated PBM side via rebates. I also dig into why the 'Association Health Plan' rule change in 2024 effectively locked small businesses out of the market.