According to health care consulting firm Avalere, over 30 percent of states’ Exchanges will have one insurance company offering government approved individual market health insurance policies. We’re seeing this situation develop here in North Carolina as the 2017 health coverage enrollment period kicks off November 1.

John Goodman’s latest piece in Forbes explains the two spirals that Obamacare is currently experiencing; health care premiums spiraling upwards and patient choice spiraling downward, since two-thirds of plans offered on the exchanges are built off narrow networks:

The Blue Cross offering in Dallas originally looked like a high grade employer plan. But like two thirds of the plans nationwide, the insurer has now switched to HMO coverage only. There is not a single exchange plan in Dallas that currently covers the highly prestigious Southwest Medical Center or the equally renowned Children’s Medical Center. Ominously, the only plans that appear to be avoiding losses are ones that look like Medicaid and are run by Medicaid contractors.