"If you start insuring a bunch of previously uninsured people, without any choice but to take them no matter what health conditions they bring to the table, then the average costs per customer have to go up." - this is the gist of the "simple math" argument against the ACA.
And actually, that's pretty undeniably true.
In the short term.
But the financing of the (heretofore) uninsured will shift from hospitals (and other providers) to insurance companies (along with the premium subsidies from the federal government). Hospitals have been trained over recent decades to inflate what they charge to cover the significant percentage of uninsured patients whose treatment they often eventually have to write off. Of course, this is why they've been able to offer insurers far lower pricing for the same procedure for which they charge private citizens a far higher rate. For many of these, they never receive any payment at all; the ones that do pay usually require service from an inflated staff/paid external billing service to deal with all of the follow-up payment issues. So in the short term, yes, the cost of insurance is going to increase. But in the longer term, if health care providers should be able to reduce their charges because there will be a higher percentage of treatment for which they are paid. If they don't, new providers should be able to step in and improve the competitiveness of the marketplace, which will reduce what insurers have to pay.
The real trick is going to be to get insurers to return this money to the pockets of customers in the form of reduced premiums, rather than lining those of stockholders. But if they don't it won't take long until new insurers step in to address this inflated market, too.
So I still don't know how I feel about the whole program, but I'm not going to jump to a conclusion based on the short term increase in premiums, even should it prove to be significant.
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