It’s open enrollment time for health care, but exchange traded funds (ETFs) might feel the pinch of limited menu options many employers are providing.

Many employees are looking at their possibilities and finding that their options are few and that coverage may be either sparse or expensive. Typically the offerings now include a health plan with a financially daunting feature: a high annual deductible that is likely to be $1,100 or more for an individual, and much higher for family coverage, reports Milt Freudenheim for The New York Times. And conventional insurance deductibles are actually one-third as high as these.

High-deductible plans are the only ones available at many companies. A lower premium plan may not compensate for the huge out-of-pocket expenses they will make before reaching the high deductible. Much of it is a personal lifestyle choice and individuals will have to decide what works for them.

With fewer options on the menu and skyrocketing deductibles, will people be willing to pay out of pocket? If not, it could hurt the health care and pharmaceutical industry. After all, as consumers have to spend more of their own money, they might be more selective in how they use it.