Sixteen years after passage of the Affordable Care Act (Obamacare), America has accumulated enough experience to ask a question that extends beyond any one administration or political party: Where did the money go?

The Affordable Care Act fundamentally reshaped American healthcare. Millions gained health insurance, and protections for patients with pre-existing conditions became permanent law. Those achievements deserve recognition. But another question deserves equal attention — not whether more Americans possess an insurance card, but whether the economics of healthcare have evolved in the public’s interest.

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