When we talk about the Affordable Care Act, we talk about the millions of Americans newly insured under the law. Or the state marketplaces, the Medicaid expansions. Or the Web site kinks. But a host of cost-cutting initiatives are built into the legislation, and partnerships with health providers nationwide — big and small, urban and rural — reduce government spending. The Affordable Care Act caused a major shift in the country's ability to provide people with health-care coverage. But cost-containing remains a challenge: When you give people insurance, they're likely to go out and get the care they weren't getting when they were uninsured. That's a good thing — but it's going to add cost to the program.