Now, I realize you knuckle-draggers who concern yourselves with cost of government will be dismissed as a “debt scolds” by the platinum-coin crowd. Still, there are around 10 million customers who purchase their health care through HealthCare.gov and state-run offshoots. With no effective national reform, that number will likely grow. Although these consumers have fewer choices, they will still receive financial assistance to offset the rate hikes. A spike in rates on the benchmark plans means more subsidies. Someone has to pay for this new welfare program.

So yes, Bill Clinton was right to point out that ACA premiums will increase for middle-class Americans who don’t qualify for subsidies. “So you’ve got this crazy system where all of a sudden 25 million more people have health care and then the people who are out there busting it, sometimes 60 hours a week, wind up with their premiums doubled and their coverage cut in half,” he said, describing a long-time conservative appraisal of the law. Really, it’s just a new welfare program.

Unlike the media seers who saw Obamacare paying for itself, magically bending the cost curve in the right direction and creating vibrant pretend marketplaces that offer uninsured Americans an array of affordable choices, I can’t see the future. The trajectory of the law, though, offers us two choices, broadly speaking.