Any significant reform would require major realignment of the health care sector, which is now the biggest employer in at least a dozen states.

The actions have raised questions about why it took public pressure before the companies altered their programs.

News from AmWINS, The Guardian Life Insurance Company of America, PreferredOne, The Standard, Wellbeats

Blue Cross Blue Shield is urging Congress to boost the ACA marketplace by increasing subsidies and putting in place a reinsurance program.