As the number of people covered by high-deductible health plans soars, some insurers and employers are easing the strain on consumers’ wallets by covering certain benefits like doctor visits or generic drugs before people have reached their plan’s deductible.

While the political world focuses on the Affordable Care Act, changes have been occurring for the many more Americans who get health insurance through work. The biggest change: rising deductibles, which are transforming the nature of health insurance from more comprehensive coverage to skimpier insurance with higher out-of-pocket costs.

In California, it is not unusual for patients to be hit by large, unexpected medical bills when they are unwittingly treated by someone outside their insurance company’s network.

Changes in the way small and mid-sized companies are regulated by the Affordable Care Act could make a substantial difference to more than half of Orange County’s workers and their families — and both they and their employers could benefit.

State health insurance exchanges created under the new health care law are in turmoil. By contrast, the employer market — where the majority of Americans still get their coverage — seems like a bastion of stability.

The number of Americans without health insurance declined to 9.1 percent last year, according to federal data released Tuesday. A set of maps released by the Census Bureau suggests an obvious way to decrease the uninsured rate even more: expand Medicaid in the 19 states that haven't.