When patients walk into Dr. Michael Pramenko’s office in Grand Junction these days, they often walk in worried.

Already, residents of Colorado’s Western Slope pay more for health insurance than just about anybody else in the country while also having a smaller selection of insurers to choose from. The Republicans’ health care bill in Congress — which may yet be revived — could up their costs even more.

And now, the Western Slope is bracing for more possible bad news about its health coverage. This month, Wall Street analysts who met with insurance giant Anthem reported that the company is “leaning toward exiting a high percentage” of the Affordable Care Act exchanges in which it currently participates. If that happens, it could leave as many as two-thirds of the counties in Colorado with no or only one insurer available on the state’s health insurance exchange. Almost all of them are in rural mountain areas.

“It would be devastating to our exchanges if they dropped out,” Lt. Gov. Donna Lynne said.

And all these looming threats are weighing on patients, said Pramenko, a family medicine physician who is a past president of the Colorado Medical Society. Last week, for instance, he saw a 57-year-old patient who is already paying $1,000 a month for coverage.

“He doesn’t like the Affordable Care Act,” Pramenko said, “but now he’s wondering if he’s going to have any way to buy insurance next year.”

Lynne and others cautioned against premature panic.

Read the full story in The Denver Post.