Um, wrong. There are almost no government regulations controlling health care expenses. The insurance companies operate with basically no oversight. There are no rules, no structure, nothing. They do what they want. The ACA is the first time any reasonable controls were put on the insurance business (can't drop ppl for pre-existing conditions, must charge women the same as men, birth control must be covered, etc etc). Make no mistake, it is the absence of government regulation that is contributing to these costs going up. We could have controlled them with single payer, but the Republicans wouldn't agree to it, knowing full well that without single payer, costs would go way up, and everyone would blame Obama.  This is at the feet of the Republicans. You can thank them for soaring medical expenses.