It originally did a substantial number of things to limit cost increases

- the individual mandate - % required spending on actual Medicare care by health insurers (limiting administrative and marketing expenses)

But each of those elements were later removed either legislatively or judicially.

> % required spending on actual Medicare care by health insurers (limiting administrative and marketing expenses)

That part stayed in. Note that this actually isn't relevant for most people get their insurance through an employer who self funds their plan.

https://www.cms.gov/marketplace/private-health-insurance/med...

Also they removed the requirement to have end of life care discussions ahead of time. Demonized as "death panels" by the right IIRC. Which was ironic given it would surely have saved a ton of money.