Former Bush administration Health and Human Services official Tevi Troy probes within a new Commentary magazine article “three failed promises” linked to the so-called Affordable Care Act.

President Obama and the law’s Democratic proponents emphasized three promises when promoting the health-care law. First, it will provide “universal coverage.”

Second, it will “bend the cost curve”—Washington-speak for reducing costs.

Finally, it will not take away your current health-care plan if you want to continue with it. …

… The primary promise was universal coverage. In the year that preceded the law’s passage, President Obama emphasized over and over again the number of Americans who were uninsured, which ranges from 30 million to 47 million, and explained that the nation had a moral imperative to cover those who could not find coverage on their own. …

… But what would universal coverage even mean? One complicating factor was that the recession increased the number of the uninsured by 6 million. So when Obama officials set as their goal the signing up 7 million people for insurance in the first year, they were in fact setting a low bar for success—they were only aiming for a net increase of 1 million people who had never been insured before. In addition, the Congressional Budget Office originally estimated after the passage of the law that, in 2019, there would be 54 million uninsured if it did not pass. After its passage, the CBO predicted, there would be only 22 million uninsured, a reduction of 32 million uninsured individuals. Of those 32 million, the CBO said half would be covered by the new “exchange” system, and half through the expansion of Medicaid. Then, in 2013, before the law was even implemented, the CBO came up with the new estimate: There would be 31 million uncovered Americans in 2019.

These numbers do not provide much confidence that the government even knows how many people are uninsured or how many the government can afford to insure. But at the very least, we’re looking at somewhere between 20 and 30 million who will remain uncovered. It would be more than fair for the American people to ask if the law justifies its huge costs when it comes nowhere near providing “universal coverage.”

The second promise was to reduce the cost of health care, specifically the cost of premiums. Universal health care would provide greater economies of scale for insurance companies, while new regulations would keep insurance companies and doctors from getting too greedy. On numerous occasions, President Obama promised that his reforms would reduce the cost of premiums by $2,500 for a family of four.

This is not going to be the case. Using the same methodology that Obama used to come up with the $2,500 figure, health-care expert Avik Roy found that costs per family of four would increase by $7,450 by 2022. Furthermore, the cost hikes in certain states are going to be far worse, including a 41 percent increase in average premiums for Ohioans in 2014, a 72 percent increase for Indianans, and a whopping 198 percent increase for Georgians. That figure is clearly an outlier; a recent Manhattan Institute analysis shows an overall average increase of 41 percent. Whatever that is, it’s not a $2,500 decrease. …

… The third promise was that if you like your health-care plan, you can keep it. During his year of salesmanship, President Obama mentioned it nearly every time he spoke about the act, often stating it more than once in the same setting. The exact wording of the comment varied over time, but the political strategy behind the statement was clear: If you were among the 85 percent or so of Americans who already had insurance, ObamaCare would have its impact on other people, not on you.

The early indicators are not encouraging.