Parts of the country are in jeopardy of not having an insurer offering Obamacare plans next year. Many counties already have just one insurer offering health plans in the Obamacare marketplaces, and some of those solo insurers are showing signs that they are eyeing the exits.

1. Obamacare Is Collapsing
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According to The New York Times, Parts of the country are in jeopardy of not having an insurer
offering Obamacareplans next year.
Many counties already havejustone insurer offering health plans in the Obamacare
marketplaces, and someof those solo insurers areshowing signs that they are eyeing the
exits.
Humana announced this year that they’d be leaving the markets altogether next year. That
means there are parts of Tennesseethat will have no insuranceoptions unless another insurer
decides to enter.

2. Obamacare Is Collapsing
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And Anthem, which operates in 14 states, is getting nervous, an industry analysttold
Bloomberg News this week. Its departurewould be a much bigger problem. According to an
analysis of government data by Katherine Hempstead at the Robert Wood Johnson
Foundation, Anthem is currently the only insurancecarrier in nearly 300 counties, serving
about a quarter of a million people.
As you can see on our map of thosecounties, an Anthem departurecould leave coveragegaps
in substantial parts of Georgia, Missouri, Kentucky, Ohio and Colorado, as well as smaller holes
in other states. In places where no insurancecompany offers plans, there will be no way for
Obamacarecustomers to usesubsidies to buy health plans.
Without an option for affordable coverage, they would become exempt fromthe health law’s
mandate to obtain coverage. A resultcould be large increases in the number of Americans
without health insurance.
The AffordableCare Act set up new markets for people who don’t get insurancethrough work
or the government. About 11 million people bought coverageon those state markets last year.
But the systemdepends on the voluntary participation of private insurancecompanies. And
some parts of the country have proved morepopular for insurers than others.
In the last year, several large commercial insurancecompanies decided to stop offering
insurancein the markets. And some carriers that continued to offer Obamacareplans scaled
back on the number of counties they served. In general, the places without much remaining
insurancecompetition tend to be ruraland expensive. (These areas tend to have fewer
hospitals and doctors to choosefrom, reducing the ability of insurers to negotiate lower
prices.)
There are a number of solo-carrier counties served by other companies, but none by as many
as Anthem, Ms. Hempstead’s analysis shows. Cigna, thecompany with the next-largest

3. Obamacare Is Collapsing
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potential impact, is the only carrier in 14 counties, containing about 100,000 insurance
customers.
Anthem could well stay in the markets. Itmay simply be floating the option of departure to
improveits negotiating position with the Trump administration over various regulatory
requests. Or it may be expressing anxiety about the future. Insurers around thecountry are
worried about the policy environment surrounding theAffordableCare Act. Mr. Trump has
said that the health law “will explode” — a comment that may suggesthe will do little to help
the markets, or could even set the fuse.
When insurers left communities in recent years, the Obama administration and local officials
worked hard to recruit replacements. The Trump administration might not do the same. So
far, no carrier has come forward publicly to say it will servethe counties in Tennessee that
Humana is leaving.
Insurersaremaking initial decisions about where to sell their products and how much to
charge. But the final lineup of insurers is still several months away. Somestates require
companies to file initial requests this month, and the Trump administration has asked for price
proposals in late June. If, after that, insurers decide the political or regulatory outlook looks
less favorable, they will still have severalmonths to leave the markets.