In the first four months of this year, the number of Americans who had health insurance has been declining, and in some states, it has fallen so much that it’s been as if the number was shrinking for a year.

So it’s not surprising that companies like Humana and Cigna are taking the lead.

That is, until the Senate passed the Affordable Care Act in July.

This year, Humana announced it would be scaling back the number it offers.

Cignas also announced its plan to reduce its participation in the marketplaces, which could have cost the company millions.

The House voted in August to repeal Obamacare, but not before some insurance companies had already started rolling out their own version of the plan, which would be even more restrictive than the Affordable Act. 

As the insurance marketplaces were struggling, health care analysts were expecting the next wave of consolidation.

The result has been a slow-moving rollout of the law. 

But now, as the markets have opened, the data suggests that a few insurance companies are taking it seriously. 

A new report from the Kaiser Family Foundation found that health care providers, such as hospitals and doctors, are increasingly adopting the ACA’s rules and policies.

“The marketplaces are in a slow and steady transition,” said Jennifer Elzea, the Kaiser research associate who co-wrote the report.

“The only thing keeping us from seeing a complete collapse is if the insurers start dropping out and all of these insurance companies go bankrupt.” 

One of the first insurers to drop out of the exchanges was UnitedHealth Group, which announced in March that it would leave the market by the end of the year.

The company had been a key player in the health care marketplaces through 2016, and this was the first time the company had not been involved since. 

The plan that was created by President Donald Trump and Vice President Mike Pence to replace Obamacare, called the Patient Protection and Affordable Care Reconciliation Act, or PPACA, was meant to be a transition.

But instead of being the first step toward a healthier, more affordable system, the ACA was quickly followed by the Medicaid expansion and by the health insurance market exchanges that were set up under the ACA. 

Many insurance companies, including Humana, said that they planned to phase out their participation in exchange plans, and that they were going to be more cautious about what they do, said Elzeas co-author, Michael E. Moffitt, a professor of health care policy and economics at the University of Minnesota Duluth. 

“It was just a matter of when, not if, the insurance industry would stop selling in the exchanges,” Elzeay said. 

Some insurers, such.

Health Care Service Corp., which had a presence in the marketplace until late last year, said on Thursday that it planned to leave by the middle of next year, and would be a smaller player in 2017. 

HHS, which had more than 10 million people in the markets in 2017, has been pushing for more competition, and it has promised that it will be offering more coverage to lower-income people.

That has led to a lot of insurers dropping out of exchange plans. 

Insurers such as Blue Cross Blue Shield of Minnesota, which has a market presence in seven states, announced on Thursday it would drop out. 

Another insurer, Health Net, which is also based in Minnesota, announced it will also exit the exchanges next year. 

And a third, Molina, said it was going to stop offering exchange coverage next year in exchange for a new type of plan. 

While insurers have been pulling out, the industry continues to roll out.

On Thursday, Anthem, one of the leaders in the industry, announced that it was rolling out a plan that would provide free coverage to all Americans. 

In addition to the federal government, insurers such as Cignans, Humans and UnitedHealth have also joined the push for a stable and stable insurance market, Moffitt said.

The idea is that if there is a sudden disruption, the system can go back to normal, said Moffitt. 

Even if some insurers are leaving the exchanges, they’re still playing a key role in the healthcare system. 

If there are only two insurance companies in the individual market, they control the market and they control who can get covered, Moffit said.

If you have two insurers in the same state, you don’t have as much control. 

It’s an interesting time for insurers.

In the beginning of this decade, the Obamacare exchanges were just a few states, and there was no way to predict what the future would hold.

Now, the market has opened and insurers are beginning to move into states that have expanded Medicaid.

Insurers will continue to compete with one another for market share, Moffis said.

“They’re going to see competition in the future,” he said. 

 The ACA is a complicated and evolving system