Narrow networks are going to become more common and perhaps even narrower.

Patients and consumer advocates have been raising alarms since the implementation of the Affordable Care Act about the limited number of providers included in many ACA plans, but insurers say that that's the only way they can turn a profit.

A report of ACA marketplaces in 18 states and the District of Columbia by McKinsey, the consulting giant, found that three-quarters of the plans available will be health maintenance organizations or other types of plans that strictly limit which hospitals and clinics a beneficiary can access in the area.

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