A health trade-off that's here to stay: Lower cost, limited choice

Traditionally, there were a few ways that health insurers could keep premiums low for individual health plans. They could select people with no prior health problems, to limit the chances of getting stuck with big hospital bills. They could pare back the services and products they offered to avoid ones that could be expensive, like maternity care or prescription drugs. They could increase premiums or deductibles so their customers would pay a larger share of any eventual bills. By changing the rules, the Affordable Care Act pushed health insurers toward a new strategy: limiting the choice of doctors and hospitals they'll pay for.