The report cites a couple recently relocated to Williamsburg from Pennsylvania to be closer to family. Ken McFarland and his wife had ACA plans with Anthem, and McFarland, who worked in a steel mill, had originally planned to retire at 65. But the move necessitated early retirement, and McFarland, now 63, says he’s considering going back to work.

Neither he nor his 60-year-old wife are old enough to qualify for Medicare, and it was already a stretch to pay for the coverage they bought on the exchange.

Now they have to start all over, finding other doctors—assuming they can afford coverage at all—and McFarland is concerned that they might be shut out altogether or have a single choice for coverage.

Pete Salant, in Virginia Beach, is not only worried about his own medical coverage but the survival of his business. Salant launched a new career instead of retiring, qualifying as a clinical social worker and opening a cognitive behavior therapy center.

Not only is Salant worried about his own coverage—in the report he says, “it looks like we’ll essentially be paying the same amount or more for less insurance”—but many of his patients are ACA customers.

He’s also worried that if they aren’t able to find affordable coverage he’ll lose them as clients.

In addition, he says many are likely to postpone treatment until matters become considerably more serious—and then have to pay out of pocket or go without.

In the report, Salant says that if the health care climate in 2009 looked like the present, he would have forgone his second-life career choice.