On June 27, 2017, the Centers for Medicare and Medicaid released an updated map showing availability of insurers through the exchanges for 2018.

 

US counties w few or no ACA Marketplace insurers

 

An accompanying CMS press release noted that 49 counties including 36,000 active exchange participants currently have no insurers offering coverage through the exchanges for 2018. These counties are apparently located in Ohio, Indiana, and Missouri. 1300 counties with 2.4 million exchange participants currently only have on insurer available for 2018.

The press release asserts that HHS is working together with state insurance regulators to explore all options under current law to address this situation. In fact, insurance regulators in Washington state and Tennessee have been able to work with insurers to cover counties that were expected to be bare and the final deadline for insurer changes to qualified health plan applications is not until August 16, 2017.

The press release claims that this situation demonstrates “the damage the Exchanges have done to the individual and small group insurance markets.” It fails to note that a number of insurers and state regulators have identified continued uncertainty as to whether the Trump administration will enforce the individual mandate and reimburse insurers for cost-sharing reductions as key factors in insurer withdrawals and premium increases.