Rationing? Call it what you want.
Insurance exchange to bar hospitals with high C-section rates.
Beginning in 2019, Covered California will exclude hospitals in the Golden State that have a Caesarean rate higher than 23.9 percent. The decision is intended to reduce the number of medically unnecessary Caesarean births, not just because of cost but because of the risks for mother and baby. (Modern Healthcare)
ACA is NOT insurance. ACA is more like a co-op, a communist-like shared cost pool. All people (all risks) are “forced” to jump in the pool evenn if they can’t swim and pay what they can and take out what they need.
Constant tweaking and extreme command and control must be applied for the plan to break even financially.
Since some issues cannot be controlled, an aging demographic for example, increasingly expensive R&D, rationing and behavioral controls (wear your seatbelts) MUST be applied from time-to-time.