<P> A 2015 study found 14% of privately insured consumers received a medical bill in the past two years from an out - of - network provider in the context of an overall in - network treatment event . Such out - of - network care is not subject to the lower negotiated rates of in - network care, increasing out - of - pocket costs . Another 2015 study found that the average out - of - network charges for the majority of 97 medical procedures examined "were 300% or higher compared to the corresponding Medicare fees" for those services . </P> <P> Some 47% of the 2015 ACA plans sold on the Healthcare.gov exchange lacked standard out - of - network coverage . Enrollees in such plans, typically received no coverage for out - of - network costs (except for emergencies or with prior authorization). A 2016 study on Healthcare.gov health plans found a 24 percent increase in the percentage of ACA plans that lacked standard out - of - network coverage . </P> <P> The December spending bill delayed the onset of the "Cadillac tax" on expensive insurance plans by two years, until 2020 . </P> <P> The average price of non-generic drugs rose 16.2% in 2015 and 98.2% since 2011 . </P>

What were the reasons for passing the affordable care act