In this Monday, Dec. 4, 2017, photo, Gail Trauco, owner of The PharmaKon, left, talks with Jordan Rubio, her office manager and son, while working in her home office in Peachtree City, Ga. Trauco's insurer is eliminating her company's policy known as a preferred provider organization, or PPO, replacing it with a health maintenance organization, or HMO, a change that would limit the choice of doctors for her five employees. Her annual costs were scheduled to rise nearly $10,000 in 2018. (AP Photo/David Goldman)
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