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Several Central Virginia localities next year will have the biggest insurance premium increases under the Affordable Care Act in the entire country.

The premiums offered on the individual marketplace by the Affordable Care Act, also known as Obamacare, will increase across Virginia and in most of the country in 2018, but people in the city of Charlottesville and Albemarle, Fluvanna and Greene counties who are ineligible for subsidies will see premium increases of between 195 percent to 247 percent in 2018, according to federal data. The average increase nationally is 17 percent to 35 percent.

Most people — about 70 percent of those on individual plans — will see rate increases absorbed by government subsidies, and some may even see lower premiums. The highest increases primarily affect the self-employed who make more than 400 percent of the poverty level — or $47,520 for an individual.

The subsidy cliff falls particularly hard on the Charlottesville area’s entrepreneurial community, where the 2018 premiums are forcing difficult conversations about money, careers and even moving out of the region.