This five-page article from the New England Journal of Medicine (NEJM) identifies the main reasons why Obamacare will likely fail to manage health care costs.  This article is a clear statement of the main weakness of the ACA. This article can be used to help you justify greater investment in Worksite Wellness programming. As the authors state, the ACA expands eligibility for Medicaid, creates new subsidies for coverage for large numbers  of the uninsured, and changes the terms under  which  insurance can be sold to persons in the non-group market. The new federal spending, amounting to $1.2 trillion through 2022, is offset primarily through reductions in Medicare provider payments. The ACA also contains provisions that, it is hoped, will ultimately slow health care spending, including accountable care organizations, value-based purchasing programs, and bundled-payment pilot projects. However, the payment provisions and pilot projects fail to address a flawed financing system whose incentives promote more spending, not better spending.  Published: 2012