This was predictable; there are incentives.
That it wasn’t predicted by the administration (or other) analysts whose job it was/is to predict these things is a testament to the complexity of the system. Nobody has any idea what the outcomes of policies will be in such an environment.
I would argue that when the system gets to be this large (complex), the only rational new policy is less policy. This is, to a large extent, why the Republicans lack of an alternative to Obamacare is a good thing and a sound (if inadvertent) policy. This is why Senator Ivy has only one policy in Washington; he always votes “no”.