It's not that binary. Strict rules on insurers essentially means shared. Shared by law requires trust in government spending, something there is little of and the spending is volatile per cycle.
It is binary. Pre-ACA options might have been cheaper because sick people weren't in the pool. If you want to cover old and sick people, then you have to pay more. Doesn't matter if it's taxpayers paying or taxpayers paying via insurance premiums, it has to come out of someone's pocket.
Most of that is not true if you recognize costs are as much of a problem as distribution. When you only target recipients/insurers/payers instead of the providers with these rules, it sure can seem like the only option is to have most people pay more. And then treating that as the only way, stating it as fact, and making the discussion binary limits true solutions to these problems from even being discussed.
Insurance premiums when people with pre-existing conditions were not covered are lower than when people with pre-existing conditions are forced to be covered. That statement would be true no matter how much providers are getting paid.
Lack of supply of providers or fraudulent billing by providers is a separate cause of increased insurance premiums, but I don't see what ACA has to do that, and if anything, healthcare spending increases are slowing down since the passage of ACA, and premiums are even decreasing in many parts of the country.
My original response was to your claim that freelancers were better off in pre-ACA times, to which I wanted to point out that was only because people with pre-existing conditions were denied insurance. Nothing in ACA has caused the amount paid to providers to increase.
