"What's not clear is whether the changes in law made by the No Surprises Act -- which takes effect Jan. 1 -- will have the unintended consequences of shifting costs and leading to higher insurance premiums.... Some predict it may slightly slow premium growth. The reason.... is that a rule released Sept. 30 by the Biden administration appears to 'put a thumb on the scale' to discourage settlements at amounts higher than most insurers generally pay for in-network care."