In Washington, most of the 290,000 people covered by insurance plans they purchased on the individual market received letters this fall telling them that their plans are going away. That's because under the Affordable Care Act, insurance plans must meet new requirements, including limits on how much money patients spend in out-of-pocket medical expenses, and they must cover 10 so-called essential benefits such as preventive care, prescription drugs and maternity care. So all 90,181 people with insurance coverage from Regence BlueShield have learned their plans will be canceled, as did all 60,000 people covered by Group Health Cooperative.