All U.S. Counties Will Have Insurer on Health Exchange. But Half Will Have Only One.

Date: October 02, 2017

The deadline for health insurers to exit ACA exchanges was last week. While all U.S. counties will be covered with a health insurance option, 50 percent will have only one, and it’s going to be costly.

After months of health insurers warning that they would exit Affordable Care Act exchanges, insurance companies faced last week’s deadline to sign federal agreements to either stay or go. For the most part, they stayed.

As of now, all U.S. counties will have at least one insurer participate on their health exchange in 2018, according to The Wall Street Journal. In the monthslong build up to last week’s deadline, nearly 145 counties faced concerns at some point of having no insurer in the marketplace. This dangerous uncertainty forced many state officials to seek out substitute insurers or to negotiate over rate hikes to persuade insurers to stay.


Large insurers—such as Cigna Corp., Health Care Service Corp., Molina Healthcare Inc., Highmark Health and Independence Blue Cross—had seemed to be positioning an exit prior to the deadline. Many did decide to exit select state exchanges, but are continuing ACA coverage in other states. For example, Cigna announced its exit from Maryland’s exchange, but will maintain ACA plan offerings in its other coverage areas. Molina is exiting Utah and Wisconsin exchanges, which was disclosed ahead of the deadline. But Molina will continue offering ACA plans in seven other states. 

Nearly 50 percent of U.S. counties will likely have only one insurer on their exchange next year, according to WSJ. Thirty percent are positioned to have only two options. While limited coverage is better than none, many state officials cut deals to raise rates. In Mississippi, the only insurer on the exchange is planning a 47.4 percent average rate increase. Anthem Inc.’s rates are set to rise 41.2 percent in Kentucky. So, employers in many states will be forced to make difficult decisions or re-shuffle their plans.

In a statement, the Department of Health and Human Services said, “Insurers have been fleeing Obamacare’s individual market, leaving nearly half of our nation’s counties with only one coverage option. Americans are once again facing skyrocketing costs and plummeting choices because of Obamacare’s fundamental failures.”

The unfortunate consequence is that rising premiums strain small business owners’ ability to offer health benefits to their employees.



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