As open enrollment starts Tuesday on the Affordable Care Act exchanges, consumers in some parts of the country are bracing for huge rate hikes, while many others are preparing to change insurers and likely doctors.

The crazy quilt of 2017 changes is creating angst among both supporters of the law and consumers under 65 who don’t get their insurance through work. And it comes as enrollment needs a big boost, especially of younger, healthier people to help offset insurers’ costs of covering the sicker people who have signed up so far.

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