Pre­mi­ums will increase because –

1) First round pre­mi­um set­ting was over­ly aggressive
2) Mar­kets with lim­it­ed com­pe­ti­tion could see larg­er increas­es because they can
3) Some car­ri­ers with insuf­fi­cient mar­ket share could leave the mar­ket, reduc­ing competition
4) Pres­sure to expand provider networks
5) Insur­ers will react to reduced fund­ing lev­els for rein­sur­ance in 2015

Then again, maybe they won’t be so bad after all –

1) Growth in health care costs slow through 2012 (though picked up in 2013)
2) Enroll­ment in Exchange plans should be high­er in 2015 than in 2014
3) Cost shar­ing in the sil­ver tier (most often select­ed) is high enough to cut utilization
4) Increas­ing size and attrac­tive­ness of non group mar­kets could inten­si­fy with competition