We’re learning more about the Affordable Care Act and how it will affect Alabamians. Earlier this week we told you some Blue Cross Blue Shield customers are crying foul after getting word rates are going up dramatically. One of those customers is John Bunkley. He and his wife have individual coverage, and each of their premiums are doubling. One hundred twenty four a month I think it was, and now it’s going up to like $250 or something for each of us, he said. As Alabama’s rates spike, other states are reporting dramatic drops in rates. Earlier this year, the Society of Actuaries predicted Vermont’s rates, for example, to see a big drop. Experts say this can be attributed to the fact that some states already ban underwriting, meaning sick people don’t pay higher rates like they do in Alabama. Rates on average are higher, and more healthy people currently opt out of buying insurance in those states.Now that being insured is required, more healthy people in states like Vermont are expected to buy in. Their good health and low risk bring premiums down for everyone. The opposite is the case in Alabama. In Alabama, it means sick people can buy coverage at good rates, said Dr. Mike Morrisey with UAB’s Lister Hill Center for Health Policy. In Vermont it means healthy people have to participate. So they join, and that drags the average premium down.No matter what state you’re in, the Affordable Care Act will likely affect you at the doctor’s office as more people seek care. Emergency room workers are forced to hang on to people, or try to get them to outpatient care as much as they can, said Dr. Greg Myrick with Compass Urgent Care, which of course overloads doctors.Myrick said the amount insurance pays out to doctors is also expected to drop. It’s lower payments per patient, which is of course lower revenue and lower pay, he said. That cost is passed on to patients in the form of higher bills. Bunkley says for his family of four, it’ll mean cutting back elsewhere. That means we’re going to go out less, he said. I’m sure a lot of other people are too, so that means businesses are going to take in less money. It’s the wrong way to go.Blue Cross Blue Shield currently insures more than 80 percent of the individual marketplace in Alabama. Dr. Morrisey says in a year or two things may ease up for customers in Alabama as more insurance companies enter the marketplace.