This is an archived article that was published on sltrib.com in 2016, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

Despite all the misleading hyperbole about how the Affordable Care Act was "socialized medicine" or a "government takeover of health care," the fact is that the plan also known as Obamacare bent over backwards to keep the same old private health insurance companies in the loop.

But there is increasing evidence that that nod to the private sector has become the ACA's weakest link.

The number of private companies offering approved Obamacare plans on state and federal exchanges is shrinking. For example, Humana announced this week that it was dropping its participation in the Utah market, leaving only three options for those seeking to purchase subsidized plans in the state.

And the premiums those companies charge are rising, here and elsewhere, undercutting the care act's claim to be affordable.

Humana follows the nonprofit cooperative Arches Health Plan out the door in Utah. Federal officials say affordable — less than $75 a month — health plans will still be within reach of some 80 percent of Utah's exchange buyers, but fewer choices mean less price-lowering competition.

It is possible that those who run private health insurance plans — like those who sell EpiPens and insulin — expect that the product they sell is so crucial to people's lives that their customers, and/or the government, will just grit their teeth and pay whatever is charged.

But neither our households nor our government can afford to keep up with ever-rising costs. If health care is going to be within financial reach of every American, which is a minimal requirement for any society that considers itself civilized, something is going to have to give.

And if the private sector insurers want to stay in the game, they are going to have to find a way to provide plans that are affordable while still offering benefits people need to keep themselves and their families healthy.

Either that, or they should be the first to admit that affordable health care for all Americans and profitable arrangements for most insurance providers are not compatible goals.

When the law was being drafted and debated, it was probably a political necessity not to make mortal enemies of the big companies that would suffer, if not go away altogether, if the ACA went forward as a totally, or even partially, government plan. Even the popular (among Democrats) public option — a government-provided insurance plan offered as an alternative to private coverage — was left out of the final bill.

The ACA as passed seemed like a dream for health insurance companies. It required all Americans, or their employers, to buy those companies' products, and provided a tax subsidy for those who otherwise couldn't afford it.

If that deal isn't enough for private insurers to stay in the market, offering the kind of competition that generally improves service and keep prices down, then both the companies and the government will have to take a hard look at what to do next.

Returning to a pre-ACA world, where far too many people went without insurance, is not an option. Neither is expecting the taxpayer to guarantee profits for insurance companies that can't keep costs down on their own.