>>Actually, costs never exceed premiums over time. Premiums go up to meet the added costs.
Not for individual policy-holders, and not entirely under the ACA or its proposed replacement, both of which pay billions to insurers to hold premiums down.
Costs exceed premiums for an individual policy-holder who (for example) develops nephrotic syndrome, cannot work, and needs a $250K transplant that has a 40-50% failure rate leading to huge ongoing costs. Pre-ACA, if such a person had an annually renewing policy, it would not be renewed (assuming they didn't just resile) or you'd be shunted off your employer's policy. Either way you're now the proud owner of a pre-existing condition.
"... They ne'er cared for us
yet: suffer us to famish, and their store-houses
crammed with grain; make edicts for usury, to
support usurers; repeal daily any wholesome act
established against the rich, and provide more
piercing statutes daily, to chain up and restrain
the poor. If the wars eat us not up, they will; and
there's all the love they bear us."
-- Shakespeare: Coriolanus, Act 1, scene 1
