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Anthem Blue Cross, Aetna, United Health Group, and Humana have all decided against participating in various states’ ObamaCare health insurance exchanges. The exchanges, which are scheduled to begin operation on October 1st, will be the only place Americans can purchase health insurance using federal subsidies granted by President Obama’s signature healthcare reform law.

According to ObamaCare’s individual mandate, all Americans are required to purchase a government-approved health insurance plan. Americans who do not obtain health insurance through an employer or Medicaid must purchase it through the exchanges in their home state. Some exchanges will be run by the state government, while others by the federal government or a combination of the two.

In the wake of the withdrawal of major health insurers from some state exchanges, state insurance officials are emphasizing that their states will have plenty of “choice” and “competition” come October 1st.

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