In the United States, insurers have long had a harder time getting the paperwork they need to cover the medical needs of people with preexisting conditions.
But now, they’re also looking for ways to reduce their costs, which could be a boon for the individual and small-business markets.
The question now is whether those changes will happen quickly enough to stave off an onslaught of new insurer competition, or whether the industry will be able to keep up with changes to the federal law that would make it easier for insurers to expand coverage.
Some insurance companies have taken steps to limit their impact.
In July, the Kaiser Family Foundation found that, despite the uncertainty of the law, insurers offered about half as many individual plans as they had before the law.
Some of the changes the industry is taking could make things even worse, according to a new analysis by the nonprofit Kaiser Family Partnership.
The law has been credited with driving down premiums and cutting out insurers who didn’t meet certain criteria, including people with pre-existing conditions.
The changes could make it harder for companies to keep the number of plans they offer up to current standards.
And they could lead to even more expensive premiums, with fewer healthy people on the market, said Jeff Greenstein, senior vice president of health policy at the Kaiser Foundation.
A key part of the Affordable Care Act is a mandate to cover all Americans who qualify for Medicaid, the federal health program for the poor.
It also requires insurers to offer coverage to people with a pre-established medical condition, such as diabetes.
In practice, however, many insurers, including Anthem, have not met that mandate.
In many cases, they have only offered plans that cover people who are too sick to get insurance, or for people with medical conditions that have been established.
Anthem and other insurers argue that they are not violating the law when they offer plans that exclude those with preterm births, pre-cancerous cancers, heart attacks or other serious illnesses.
They also argue that it is misleading to describe the rules as forcing them to offer individual plans that don’t meet the new requirements.
“It is misleading,” said Jonathan Gruber, an economist at Harvard University and one of the authors of the new analysis.
“They’re trying to be clever.
It is not true.”
Some insurers, like UnitedHealth Group Inc., have said that they will expand to cover a broader range of people and services.
But they face new challenges, as insurers have not been able to collect enough data to make that decision, and many insurers will be forced to pay more in premiums.
In states that expanded Medicaid, there are more insurers that have not yet expanded, such in Ohio and Georgia.
Some insurers are pushing to expand into some states where they haven’t done well.
They say that it will allow them to compete more effectively and get the most people into the market.
But the challenge is also that there is no clear way for insurers in the state to do this.
And while some insurers have taken other steps, such getting more aggressive about screening for pre-existing conditions, others are still struggling.
And insurers will have to adjust to the new landscape quickly if they are to keep their premiums down, said David Cooper, a senior fellow at the Urban Institute.
“We’ll be seeing insurers looking for more of a return on their investments, whether that’s in their ability to compete, or in how they plan for the future,” he said.
The uncertainty over the new law has put insurers in a bind.
Insurers may be trying to find ways to save money but not to lose business, but they are also looking to attract customers by providing better care.
But there is a catch: If they don’t find ways of keeping up with the changing landscape, they could face financial pressure to sell or cut back on their plans.
Insiders say that is a risk insurers are willing to take, and that they’re starting to see the effects of the uncertainty.
“What we’ve seen in recent months is that there’s been an overall decline in insurers’ confidence in their businesses,” said Mark Smith, a former chairman of the National Association of Insurance Commissioners, who now serves as a senior vice chairman at Blue Cross Blue Shield.
“That is something insurers are now paying more attention to as they try to understand the effects that the law has had on them.”
Some analysts believe the market for health insurance may be slowing.
But for most of the insurers in this industry, that will be a temporary situation, as the health law remains in place.
If insurers lose confidence in the law and stop expanding, they will have less money to pay doctors and other medical providers.
The insurers in that position could also struggle to compete with health plans on the federal market, which has already seen a significant drop in premiums, according at least two recent studies.
The biggest risk for insurers is that they may have to pay less money in the future for