Costs are soaring and will only continue. It has pushed insurance rates up, and will get worse, and will lead to most leaving private insurance companies which will cease to exist (current estimate is 2/3 will fall into the federal system now as businesses drop insurance plans due to soaring rates as a result of new/adjusted mandates).
Now, that news may make some happy. However, the lower middle class will be hammered. The system admits that there will be a significant group out there who won't receive any subsidies, but won't make enough to afford the plans. Plus, it will leave it in the hands of the government what will and won't be covered. If you think there will be mercy in this regard, all you have to do is consider Sebellius's response to the kid who is too young to get a lung transplant in the Philly area today. She says there is nothing she can do to intervene over the rule. However, the rule was based under a past medical reality, and not current reality. Also, the regulation allows the person in Sebellius's job to intervene and/or change the rule.
Just remember, dealing with an uncaring, bureaucratic health insurance company sucks. Dealing with a large federal department will make dealing with your insurance company look like child's play.