The phrase "red states" could get a whole new meaning if Obamacare is repealed.
A new map starkly highlights the U.S. counties that are most at risk of ending up with zero insurers selling Obamacare individual health plans next year if Congress guts the law but suspends the effect of that repeal for some time.
That map's biggest concentration of high-risk counties, marked in red, is in the southern United States. That region heavily supported Obamacare foe Donald Trump in his successful campaign for president last fall.
But the entire states of Wyoming and Alaska, as well as large parts of Oklahoma, Missouri, Nevada, Utah and Arizona, also are at high risk of ending up with no Obamacare insurers, according to The Century Foundation, the progressive think tank that produced the map.All of those states, except for Nevada, gave their electoral votes to Trump.
The "red" counties at high risk contain a total of 10 percent of the U.S. population.
The Century Foundation's analysis and map, is based on a Congressional Budget Office report released last month.
That report analyzed the potential impact of a so-called repeal-and-delay bill that was passed by the Republican Congress last year but vetoed by President Barack Obama. The bill was sponsored Rep. Tom Price, R-Ga., who is Trump's pick to run the Health and Human Services Department.
It would would dismantle certain key elements of the Affordable Care Act, but delay their actual removal.
The bill, which has been viewed as a template for possible repeal and replacement of Obamacare this year, would result in "roughly 10 percent of the population ... living in an area that had no insurer participating" in the first year after the bill became law, according to the CBO report.
There is no county currently in the U.S. that has zero insurers offering Obamacare plans.
But as of now, slightly less than 20 percent of the U.S. population lives in counties that have just one insurer selling Obamacare plans. Those individual plans — distinct from the group health coverage that most Americans get through an employer — are sold both through government-run Obamacare exchanges, as well as outside of those markets by brokers and insurers themselves.
The Century Foundation for its map considered all of those counties with just one insurer at risk of "a complete loss of competition" by 2018 under a repeal-and-delay scenarios.
The counties most at risk of ending up with zero Obamacare insurers — the ones marked in red — next year have the lowest number of potential Obamacare customers among all of the at-risk counties.
Counties that are considered vulnerable, which are marked in orange, also have only one insurer, "but have a larger customer base, making them less likely to lose all insurer participation in the first year," according to the Century Foundation.
The map could end up with a lot more red and orange in future years.
The CBO estimates that a repeal-and-delay scenario would eventually lead to about three-quarters of the U.S. population not having access to an insurer selling individual health plans.
The same CBO report estimates that 32 million more Americans would become uninsured by 2026, and that the prices of premiums paid by those people who remain in individual plans would double by that year.
The Century Foundation noted that its analysis "depicts only one possible scenario under either 'repeal and delay' or administrative actions to undermine the same policies."
Trump and Republican Congressional leaders say they want to repeal Obamacare soon and replace it with other health-care legislation. Such legislation could end up partially, or completely, offsetting the risk of insurers dropping out of the individual market.
But so far, the GOP has not produced a concrete replacement plan, much less agreed on one that is likely to draw the support of Republican members of Congress as well as the eight or so Democratic senators whose support would be needed to pass it into law.
In the meantime, people worried about the possible loss of health insurance under a GOP plan have confronted members of Congress in recent weeks to voice their concerns.