If the public exchanges succeed, they could force noprofit hospitals to cut their rates, according to analysts at Moody's Investors Service.

Many of the carriers selling individual and small-group coverage through the Patient Protection and Affordable Care Act exchange system have tried to keep premiums low by using narrow provider networks.

The narrow qualified health plan networks are affecting off-exchange networks, because some carries are selling similar plans on both markets.

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Allison Bell

Allison Bell, a senior reporter at ThinkAdvisor and BenefitsPRO, previously was an associate editor at National Underwriter Life & Health. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached through X at @Think_Allison.