It's a time of major uncertainty in Middle Tennessee.
"It's a huge blow. So what do we do - that's the big question," said Tatum Allsep, who helps music industry members find insurance through her Music Health Alliance.
With Blue Cross Blue Shield out of the health care exchange in Nashville next year, so are many doctors and hospitals. At least for now.
"Eighty-one thousand (people) with the surrounding counties no longer have access to Vanderbilt and St. Thomas today," Allsep said, "will HCA be able to handle the capacity? They say they can."
"Frustrating yes very frustrating," said Sandy Dimick with Get Covered TENN, "they're (patients are) in the middle of care right now with their providers and that’s something we want people to get some continuity with their care."
Both women are navigators, the people who help folks sign up for health care. And they both attended a meeting organized by the Dept. of Commerce and Insurance to connect navigators directly with the insurance companies.
They had a lot of questions before open enrollment begins next week. Humana and Cigna are both still participating on the exchange for the Nashville area.
"What is the wait time that is okay?" Allsep asked, "is it five months, is it tomorrow, what do you do if you're sick?"
But Wednesday they didn't feel like they got many concrete answers.
"Its absolutely going to be a challenge," said Asst. Commissioner Michael Humphreys.
For the providers sticking around, premiums are going up 40 percent in the Nashville area.
"HHS will come back and tell you based on their statistics I think upwards of 80-85 percent of people who purchase in Tennessee get a substantial subsidy that may reduce their premium to 100 dollars or less, but that doesn't account for the other 15 percent," Humphreys said.
Those in the industry blame the steep hikes on too many sick people signing up on the exchange without enough healthy people enrolled to help balance the costs.
"The people that are sick are sick with chronic conditions," Humphreys said, "it's not a broken arm, it's not something that goes away in six to eight weeks."
And while many believe the system will eventually stabilize, and the major hospitals should one day be a part of the networks again, they say it could be rough-going until we get there.
"You're gonna have to be an advocate for yourself," Allsep said, while remaining hopeful for change, "for the first time this year our opportunities in healthcare are shrinking."
