The reason is simple..we created a perverse system that ENCOURAGES insurance companies to promote profligate spending. The "medical loss ratio" of the ACA limits them to a 20% difference between premium revenue and payout.

The best way for them to increase profit is to payout as much as they can..and increase premiums accordingly. Since the ACA also has the "risk corridors" they have little downside risk to increasing premiums...the increase gets absorbed in the subsidies and anything above that gets paid off in the risk corridor payments. Their actual cost of administration does not change appreciably in such a situation..so profit becomes more of that 20% they get to keep.

Of COURSE they do not want the competition of a true catastrophic plan..such a product being available would place economic pressure to lower premiums which would mean less revenue available from that 20%.

The hospitals and drug companies are in the same situation...they benefit from higher prices and have little incentive to cut costs.

The people who get screwed are the small businesses that provide healthcare for their employees and those not receiving subsidies through the ACA. And that is what we have seen since it was instituted.

I don't like Cruz..but he really got to the heart of the matter with his amendment.