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Only one county in US remains without an Obamacare insurer for 2018

  • There has been a steady decrease in the number of counties at risk of having no Obamacare plans next year.
  • There had been 82 counties containing 92,000 Obamacare customers that were at risk of having no individual health plans offered in 2018.
  • Currently, there are fewer than 350 people who buy such plans in the only county still at risk of not having an insurer in 2018.
Activists hold signs during a Stop 'Trumpcare' rally May 4, 2017 in front of the Capitol in Washington, DC.
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Activists hold signs during a Stop 'Trumpcare' rally May 4, 2017 in front of the Capitol in Washington, DC.

And there was just one.

The entire United States, with the exception of a single small county in Ohio, is now on track to have at least one insurer offering Obamacare health coverage next year.

That's a big change from earlier this summer when at different times a total of 82 counties lacked commitments from insurers who sell individual health plans for 2018.

And the continued decline in "bare counties" provides more ammunition for Obamacare advocates arguing against Trump administration claims that the health-care program is failing and needs to be replaced immediately.

The latest potential bare area to get coverage offered for next year was Menominee County in Wisconsin, where just 47 people buy Obamacare plans on the federal marketplace HealthCare.gov.

Elizabeth Hizmi, a spokeswoman for Wisconsin's insurance commissioner, would not identify the insurer that in recent days agreed to sell plans in Menominee, saying "at this time, service areas are not public."

Insurance regulators in Ohio are trying to get an insurer to step in and offer individual health plans in that lone "bare" area, Paulding County.

"The director is still working on it," said David Hopcraft, spokesman for Ohio Insurance Director Jillian Froment.

Paulding County has only 334 people currently covered by an individual health plan sold on HealthCare.gov. Froment has several weeks left to line up an insurer to cover the county.

Hopcraft, when asked what provisions Froment was considering for Paulding's existing Obamacare customers if an insurer does not step in, said, "You know what, we're not there yet."

"The director said in a recent interview that she was just hopeful," Hopcraft said.

Ohio had been at risk of having 20 bare counties next year after the big insurer Anthem said in June it was effectively pulling out of the entire state in 2018.

But Froment in late July announced that she had obtained commitments from five insurers that would guarantee coverage from at least one insurer in 19 of those counties.

Since then, however, Froment has not been able to convince an insurer to cover Paulding County, which sits on the western edge of Ohio, bordering Indiana.

"That's a little bit discouraging," said Cynthia Cox, associate director for Kaiser Family Foundation's Program for the Study of Health Reform and Private Insurance.

"You would think one insurer would step in from a neighboring county to offer plans," Cox said, noting that such an insurer would be guaranteed a monopoly for Obamacare plans.

But nationally, Cox said, "the general trend has been a positive one" as a steady stream of insurers stepped in to cover Obamacare customers.

Cox said that over the course of the last several months 82 counties were at risk of not having an Obamacare insurer selling plans next year. Those counties contained 92,000 current Obamacare customers.

The insurer Centene has been, by itself, responsible for offering coverage in more than 40 previously bare counties in 2018, including 25 counties in Missouri. Last week, Centene said it would cover the remaining 14 bare counties in Nevada next year.

Despite that current positive trend in covering bare counties, the U.S. Department of Health and Human Services has continued to push out a negative message about Obamacare overall.

HHS's pessimistic tone about the Affordable Care Act began after President Donald Trump took office. Previously, HHS had been Obamacare's biggest cheerleader.

Earlier this year, HHS's Centers for Medicare and Medicaid Services began issuing updated maps showing counties that lacked Obamacare insurers for 2018.

On Monday, HHS spokesman Matt Lloyd issued a statement that noted the end of a federal Obamacare enrollment assistance program, and said, "Obamacare failed to create a thriving, competitive market that offers the kind of coverage people want to buy at prices they can afford."

"On Obamacare's exchanges premiums continue to surge, insurers continue to abandon wide swaths of the country, and choices continue to vanish — an unfortunate reality for the American people who are required to buy Washington-approved health insurance or pay a fine," Lloyd said.

Lloyd also highlighted an article in the Washington Free Beacon that noted that "Obamacare's Enrollment Assistance Program spent more than $1,500 for each person it helped enroll last year."

"By ending this program, which only managed to help 14,500 people sign up for Obamacare — 0.1 percent of total plan selections — CMS is saving taxpayers more than $22 million next year," Lloyd wrote.

But Protect Our Care, a leading Obamacare advocacy group, on Tuesday cited the news that there remains only one bare county for 2018 to argue against HHS's messaging.

"Republicans keep saying that many people will not have access to health care plans and make discredited claims about a non-existent death spiral," Protect Our Care said in a statement.

"The claims have been debunked by the nonpartisan Congressional Budget Office and now by the facts in the 2018 coverage map from Kaiser Family Foundation."

Anthem and other insurers that have pulled out of Obamacare markets have cited difficulties in selling individual plans at a profit, as well as uncertainty about the markets because of concern over Trump administration policies, for their decisions. Insurers have expressed fears the administration will not enforce Obamacare's individual mandate, which requires most Americans to have insurance, as well as worries that the administration will not fund key federal payments to insurers to compensate them for discounts offered to a majority of Obamacare customers.

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