Will Some American Counties Be Left Without Health Insurance in 2018?



It doesn’t appear that Congress and the White House will commit to funding crucial payments to compensate insurers for subsidizing out-of-pocket costs for some lower-income enrollees. The damage to insurance markets could be catastrophic if the approximately $7 billion in payments to insurers aren’t funded, and if core ObamaCare provisions — like the individual mandate to buy insurance — aren’t enforced.

The immense uncertainty about the future of ObamaCare has some areas wondering whether they’ll soon be without any insurance plans to buy on the healthcare exchanges.

Insurance companies are in the midst of filing premium requests for the Affordable Care Act’s (ACA) marketplaces. But before seeking those premium hikes, they’ll have to decide whether to continue offering coverage at all.

According to The Hill, for some counties in particular, the threat is looming like a dark cloud. Blue Cross Blue Shield of Kansas City announced it was exiting the marketplace, leaving 25 counties in Missouri without any carrier willing to sell ACA plans for 2018. Medica and Gundersen Health Plan are the only insurers selling ObamaCare plans in most Iowa counties, and according to their spokesmen, they haven’t made a final decision yet on whether they will stay or leave. Aetna announced it would exit its last ObamaCare markets, which included Nebraska, leaving Medica as the only carrier on the ObamaCare exchanges selling plans to the state. In addition, in Knoxville Tennessee, Humana announced it wouldn’t sell insurance on the exchanges leaving the Knoxville area without any plans for 2018. 

Obviously, more insurers could flee the ObamaCare markets if payments to insurers aren’t funded and if the individual mandate isn’t enforced — or if the uncertainty continues. There is no clear replacement path forward from Congress and the White House, and there will be no final decision for insurers’ intentions for selling plans until the fall. As a result, insurance commissioners will be scrambling to lure other insurers into the area behind the scenes.

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