Since just a few insurers, or sometimes just one, dominate the market for individuals and small businesses in some states, the law sought to increase competition in those areas by calling for “multi-state” health plans that would be offered by some insurers. The law required that at least two multi-state plans be available to consumers in 31 states by 2014 and in all states by 2017, but it doesn’t require insurers to offer the plans and most so far have opted not to. Federal officials and insurance experts say it is unlikely that the 2017 goal will be met.
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