There are discussions on the hill to bring back the Cost Sharing Reductions. Last year they were eliminated which resulted in a spike in premiums just before individual enrollment time.
A recent study suggests that not everyone will join an association health plan. That being said there are estimates that over 3 million people will be leaving the marketplace which will increase premiums even further for those who stay.
Up-coding and the games that are played on the provider end are a huge issue. This article goes into detail about a suggestion about having a contest to modify the current risk adjustment model that could save the county tens of billions a year in coding gimmicks.