Five Areas of America in Danger of Losing Obamacare Insurers

Obamacare Here Sign Joe Raedle Getty
Joe Raedle/Getty

Obamacare continues to collapse.

Here are the five places most likely to lose Obamacare insurers:

1. Missouri

Last month, Blue Cross Blue Shield of Kansas City announced it was exiting the state marketplace, leaving 25 counties without any insurer selling Obamacare plans for 2018.

Cynthia Cox, associate director of the Program for the Study of Health Reform and Private Insurance at Kaiser Family Foundation, explained, “That’s what makes the Missouri situation more troubling than some of the other places where we’ve been looking, is that without the Blue Cross Blue Shield plan, it’s not clear who’s going to move into those counties.”

2. Iowa

Medica remains the only major health insurer selling Obamacare plans in most Iowa counties and has not made a final decision as to whether it will exit the state Obamacare exchange, according to spokesman Larry Bussey. Gunderson Health Plans sells in five Iowa counties, but is still reportedly undecided about whether it will stay on the state’s exchange.  Aetna and Wellmark announced that they would stop selling individual plans next year.

In an op-ed for the Des Moines Register, Wellmark’s chairman and CEO John Forsyth explained the changes Wellmark would require in order to stay in the Iowa exchange. Changes would have to include: offering incentives for maintaining continuous health insurance coverage, limiting the special enrollment periods, offering financial help based on income and age, offering reinsurance, and allowing health insurers to offer more flexible low-cost health insurance plans.

3. Nebraska

In May, Aetna announced it will exit its last Obamacare exchanges, which included Nebraska, and only Medica remains as the sole Obamacare insurance provider in the state.

Geoff Bartsh, vice president for Medica’s individual and family business, said,“Things are still changing daily.” Bartsh, added, “We’re still looking at changes and will continue to evaluate things. We are still planning to participate in the Nebraska market for 2018. We haven’t made any final decisions on that yet.”

4. Tennessee

Humana announced in February that it will not offer Obamacare plans in the greater Knoxville region for 2018. Blue Cross Blue Shield of Tennessee announced that it will remain in the state Obamacare market, although the health insurer wants to exit the market “in the event of any post-bid changes that destabilize the market.” Tennessee’s two senators, Lamar Alexander and Bob Corker, proposed a bill to allow Tennessee citizens in areas without an Obamacare insurer to buy any state-approved plan using their Obamacare subsidies.

5. Rural America

Rural America traditionally has less competition in the health insurance market, and that remains true under Obamacare. Urban areas on average have 2.5 insurers in 2017, compared to two insurers in more rural areas.

Many rural counties only have one insurer in the exchanges, which leaves them without any Obamacare insurance options if that one insurer decides to leave the state.

Cynthia Cox told The Hill, “I think just within a given state the rural areas are probably most at risk of having no insurance company. It’s easier for a plan to set up a favorable network in an urban area, and there’s also generally just more insurers wanting to participate in urban areas.”


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