My understanding of these exchanges is one will be able to pick the kind of coverage they want. Another words if you want an HMO or a PPO or something more costly you have the choice. BCBS PPO will be one of those choices. Now, if someone who has very little income my hunch is they will not be able to acquire BCBS but medicaid only. Medicaid only or a low cost HMO is where I think one may have an issue getting prompt attention when needed. But I could be wrong. However, change from the old system was going to happen anyway, there is no doubt about it, so I do believe the changes will not stop on October, 1. I think more changes are on the way especially state by state changes.