(Bloomberg) -- A growing number of people in Obamacare are finding out their healthinsurance plans will disappear from the program next year, forcingthem to find new coverage even as options shrink and pricesrise.

At least 1.4 million people in 32 states will lose the Obamacareplan they have now, according to state officials contacted byBloomberg. That’s largely caused by Aetna Inc., UnitedHealth Group Inc. and somestate or regional insurers quitting the law’s markets forindividual coverage.

Sign-ups for Obamacare coverage begin nextmonth. Fallout from the quitting insurers has emerged as the latestthreat to the law, which is also a major focal point in the U.S.presidential election. While it’s not clear what all theconsequences of the departing insurers will be, interviews withregulators and insurance customers suggest that plans will be fewerand more expensive, and may not include the same doctors andhospitals.

It may also mean that instead of growing in 2017, Obamacarecould shrink. As of March 31, the law covered 11.1 million people;an Oct. 13 S&P Global Ratings report predicted that enrollmentnext year will range from an 8 percent decline to a 4 percentgain.

Vanishing plan

Last year in Minnesota, Theresa Puffer, 61, used Obamacare tosign up for a BlueCross BlueShield plan after leaving her jobfollowing a skin cancer diagnosis. “I would have had a hard timefinding any sort of coverage before the ACA,” Puffer said byphone.

Next year, Puffer’s plan is disappearing from Obamacare --making her one of about 20,000 Minnesotans in the same situation.To make matters worse, premiums for other plans in the state willrise by at least 50 percent, though subsidies under the law canhelp cushion the blow.

“Trying to determine which would be the best plan for mysituation is not easy,” Puffer said. Her dermatologist appears tobe out of network in other plans, she said. “I’m willing to pay ahigher premium to see him, because when you have cancer you want tostay with the same group of doctors,” she said. “I’ve spent so muchtime trying to figure out what my options are.”

Bloomberg contacted officials in all 50 states and Washington,D.C., and the 1.4 million-person estimate includes 32 states andonly plans sold on the individual “exchange” markets. In Texas,Arizona, Georgia and Missouri, insurers have pulled out, butregulators couldn’t or wouldn’t say how many people are affected.Three states didn’t provide sufficient data. Eleven states, plusD.C., said they weren’t affected.

Normal disruption

The U.S. agency that oversees Obamacare has said that some disruption isnormal, and that choosing a new plan can help people get the bestdeal.

“It’s part of the normal business cycle for insurers todiscontinue, change, and replace plans from year to year,” BenjaminWakana, a spokesman for the Department of Health and HumanServices, said by e-mail on Oct. 5. “Such changes don’t preventpeople from obtaining coverage. People can shop for new coveragethrough a transparent market.”

HHS said Thursday that it will contact people losing theircoverage and encourage them to sign up with new plans. The lawrequires all Americans to have insurance or pay a fine.

Nationwide estimates of the number of people losing theircurrent plans are higher. For example, Charles Gaba, who tracks thelaw at ACASignups.net, estimates that 2 million to 2.5 millionpeople in the U.S. will lose their current plans, compared with 2million a year ago. Gaba’s estimate is based on insurance companymembership data.

Fewer choices

For the people losing plans, there are fewer and fewer choices.One estimate by the Kaiser Family Foundation predicts that for atleast 19 percent of the people in Obamacare’s individual marketnext year there will be only one insurer to choose from.

In North Carolina, for example, a BlueCross BlueShield insurerwill be the only option in 95 of the state’s 100 counties afterAetna and UnitedHealth said this year that they would leave. Thatwill leave 284,000 people looking for a new plan, according to thestate.

“Without any significant statutory and regulatory changes on thefederal and state levels, we may face the crisis again,” said NorthCarolina Insurance Commissioner Wayne Goodwin, a Democrat who’s upfor election this year. “There needs to be a wholesalere-evaluation by leaders in Washington.”

Losing access

In Tennessee, UnitedHealth and the state’s BlueCrossBlueShield plan are pulling back, and about 117,000 people willlose the plans they have now.

Amanda Page Cornett, a 34-year-old musician and athletic trainerin Nashville, is among them. For 2015, Cornett was careful topick a BlueCross BlueShield plan that covered specialists atVanderbilt Health, to treat nerve pain stemming from a 2013accident. Her condition worsened recently, she said, and she’sworried about losing access to her doctor.

“I’m hopeful that he’s going to be able to help me,” she said ofher current physician. “I feel like now I have two and a halfmonths to figure it out before they shut me out.”

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