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63 Counties Projected to Have No Obamacare Insurer in 2018

1,472 counties will only have one insurer participating on the exchange

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September 16, 2017

There are 63 counties in the United States that are projected to have no insurer participating in the Affordable Care Act exchanges in 2018, according to a report from the Centers for Medicare and Medicaid Services.

The agency has been tracking health insurer announcements since June and creates maps to show which counties will have no Obamacare insurer in 2018. The map will change based on future announcements if more insurers exit.

The first map the agency created on June 9 showed there would be 47 counties with no insurer participating.

Since that time, the number of counties with no insurer participating in Obamacare has fluctuated, dropping to even zero at one point on September 6. During this time, many articles came out criticizing Speaker of the House Paul Ryan (R., Wis.) for saying there were counties in the United States that had no insurer participating.

Recent data from the agency, however, shows that now there are even more counties with no choice than ever before.

"This map currently shows that nationwide 63 counties are projected to have no issuers, representing over 70,000 Americans in these counties that could be without coverage on the Exchanges in 2018," the report said. "It is also projected that 1,472 counties—over 45 percent of counties nationwide—could have only one issuer in 2018. This could represent more than 2.6 million Exchange participants with only one health insurance option, which means they will not have any choices."

Insurers such as Anthem and Aetna have announced this year that they are planning exits from the marketplace, which will leave some areas with no options. A representative from Anthem told lawmakers on Thursday that the company was cautious about continuing their participation because of Obamacare's uncertainty.

Individuals who will be living in an area where there is no insurer offering coverage will still be bound by Obamacare's individual mandate to purchase health insurance or be forced to pay a penalty.

Senators Lamar Alexander (R., Tenn.) and Bob Corker (R., Tenn.) have introduced legislation that would protect these people from being penalized for not having insurance when there are no insurers operating on the exchanges in their area.

The Health Care Options Act of 2017 would waive the penalty in these cases and allow individuals to purchase coverage outside of the exchanges.

"This legislation would help those in Knoxville and across the country by allowing any American who receives a subsidy and has no insurance available on the exchange next year to use that subsidy to buy any state-approved insurance off of the exchange," Alexander said. "Second, the bill would waive the Affordable Care Act requirement that these Americans, who have zero insurance options with their subsidies, have to pay a penalty for not purchasing insurance."