In a report that is not all that surprising, the New York Times has concluded that insurers offering health care policies on the Obamacare Marketplaces are keeping costs lower by reducing the number of providers and choices available to purchasers.

An article in today's edition by Robert Pear sums it up this way: "From California to Illinois to New Hampshire, and in many states in between, insurers are driving down premiums by restricting the number of providers who will treat patients in their new health plans."

While restricting patient choice helps trim costs in the plans being offered, it also has the potential of forcing people to spend more out of pocket if they need specialized care and it's not covered, consumer advocates told the NYT.

In New Hampshire, for example, Anthem Blue Cross and Blue Shield, the only insurer participating in the state's marketplace, is excluding 10 of the state's 26 hospitals — and its doctors — from its policies.

Insurers are in many cases also cutting fees paid to doctors to Medicare levels, which a cancer specialist in New Mexico told the newspaper is "often below our cost of doing buiness, and definitely below commercial rates."

The Affordable Care Act (ACA) Marketplaces are set to begin operations Oct. 1 despite software and other problems plaguing the federal exchange and some of the state marketplaces as well.