As the bill was being debated it was my understanding that the lowering costs would come from improvements in health as a direct result of increased preventativ

As the bill was being debated it was my understanding that the lowering costs would come from improvements in health as a direct result of increased preventative care and earlier detection of disease (in the stage where it is cheaper to treat). It is impossible to have the increased preventative care come before patients' access to that care, just as it's impossible to detect illness when a patient cannot even be seen due to lack of insurance. That was the reason I said I didn't expect a reduction in price in the short-term, because it simply doesn't make sense. That doesn't mean costs won't eventually go down compared to what they would have been if PPACA didn't go into effect, but that's getting beyond my ability to predict based just on simple principles.