Nearly the entire state of Tennessee has a single Obamacare provider. In sixteen counties, none of this year’s providers want to do business.
Mississippi, Alabama, South Carolina, Oklahoma, Alaska, and Wyoming are states where there is only a single provider for the entire state. Iowa is likely to be covered by a single provider next year. Most of North Carolina, Florida, Missouri, and Arizona are also in a single-provider situation.
Enrollment for 2018 starts in November. Will the problem be fixed by then? If not, What Happens if Places Have No Obamacare Insurers?
The markets created by the Affordable Care Act have always relied on the voluntary participation of private companies. If the government set up the right conditions for the market, the thinking went, insurers would want to jump in. But, as Sarah Kliff at Vox.com has reported, the law contained no real backup plan if that vision didn’t work out.
So far, there are parts of Tennessee where none of this year’s insurers want to sell insurance next year. Other counties have only one carrier, and in some of them, that carrier is looking shaky.
If insurers do all decide to exit a market, no one is exactly sure what will happen next. Some experts have brainstormed about possible workarounds, but all would entail uncharted legal territory.
Senator Lamar Alexander of Tennessee, the state currently at greatest risk of bare counties, has introduced a bill that would create options for customers shut out of their Obamacare market. But even if Congress passed such a law, regulators would have to work very fast to make anything happen before next year’s enrollment period, which begins in November.
No Backup Plan
Vox asks What if Obamacare Insurers Falls to Zero?
Multiple sources tell me that White House staff held a meeting today to discuss cost-sharing reduction subsidies — that $8 billion Obamacare program whose fate still hangs in limbo. Ending these payments could “blow up” the health law’s marketplaces, but President Trump has so far waffled on what he’ll do about the issue. The meeting didn’t include any outside advisers or industry officials, only administration staff.
Right now there are 16 counties in Tennessee where no health insurer wants to sell Obamacare coverage. Iowa could be next: Half its Obamacare insurers announced this month that they would no longer participate in the marketplace. That leaves 94 of the state’s 99 counties with just one insurer — and regulators there aren’t totally sure that plan, Medica, will stick around.
“We don’t have any commitment from the two carriers that remain that they will be there,” says Doug Ommen, Iowa’s insurance commissioner. “They’re not required to file with us until June. Certainly we’re hopeful, but unless Congress acts, our market will continue to be very unstable.”
What happens if no one wants to sell coverage? Does the law have any fallback plan? The short answer is no. There is no backup plan for places where no insurer wants to sell Obamacare coverage.
Even before the election, some big insurers had decided that the Obamacare marketplaces were not good for their bottom lines. Aetna and UnitedHealth mostly withdrew in 2016, leaving lots of places with just one insurer.
Since the election, health insurers have only gotten more skittish. Humana announced in February that it would no longer participate. That left those 16 Tennessee counties without any plans, and many more counties with just one option.
The articles mentioned that Trump could call up providers and bully them into offering coverage. But does that make any sense from a party that wants to Kill Obamacare?
The system is set up to implode and there is no point to doing anything until it does. After an implosion, there will be bipartisan support to do something. Right now there is no bipartisan support to do anything.
The folly of House Speaker Paul Ryan’s ill-fated attempt to fix the problem is readily apparent.
His poor decision to attempt to fix the unfixable accomplished nothing useful, but it did move partial ownership of the problem to Republicans.
Mike “Mish” Shedlock
Time to fully repeal this piece of crap and let the people out of extortion prison. Those of us that must purchase our own insurance know very well that our insane premiums along with our high deductibles are the result of them taking our money and subsidizing people that either don’t pay or pay very little via subsidy.
These people are not our problem and I don’t know of anyone that is happy with what they are getting in return for healthcare. The economy is showing a major slowdown because the middle class is now forced to spend their discretionary income on healthcare.
We demand a house vote up and down to fully repeal the ACA. The only people that will be hurt are the ones that get it for FREE or are heavily subsidized. SO WHAT!
Tony Bennett said:
“We demand a house vote up and down to fully repeal the ACA.”
Well, you’ll need the Senate to pass, as well … and then DJT to sign.
And you know that will make many voters unhappy … so Congress loathe to do it.
Much easier to start a (nuclear) war with North Korea to move issue to back burner.
Victor Adam Smith said:
Tony Bennett said:
“But does that make any sense from a party that wants to Kill Obamacare?”
The joke is on the voters … at least Republican voters …
The last time I checked Alexander was a “conservative” –
“Senator Lamar Alexander of Tennessee, the state currently at greatest risk of bare counties, has introduced a bill that would create options for customers shut out of their Obamacare market.”
What happens now? The real pain begins. And that’s a ‘good’ thing.
The ‘free-shit army’ voted for this mess, and now they need to feel the pain of this disaster. I’m glad the replublican plan failed. I hope they all fail, and the pain will wake up Americans to the lie of the welfare state.
Yancey Ward said:
In areas with no subsidized policies on offer, the pressure will be on those Democrats who represent those regions in Congress. Party discipline can only go so far.
Jon Sellers said:
Looking at that map, there’s not a lot of democrats there.
Yancey Ward said:
Not yet, but there will be.
Stuki Moi said:
Brain rejected this:
“The markets created by the Affordable Care Act”
BillyBob Texas said:
Republicans would do well to back off…..
…..let the public experience some pain…….
…..and HOPEFULLY they will realize that OBAMA! and 100% of the Democrats and ZERO Republicans foisted this on them.
And pound home that message.
THEN, and only then, get the frickin’ system FIXED. But NOT YET !!
Tony Bennett said:
“The system is set up to implode and there is no point to doing anything until it does. After an implosion, there will be bipartisan support to do something. Right now there is no bipartisan support to do anything.”
As the chart from our latest tracking poll shows, 62% of the public say Trump and the Republicans in Congress are in charge of the government and are responsible for problems with the ACA from now on; just 31% say President Obama and the Democrats are responsible. As is always the case with the ACA, there are party differences; 81% of Democrats and 65% of Independents said Trump and the Republicans “own it”, but just 35% of Republicans feel that way.
Trump has also said that the collapse of the ACA would bring Democrats to the table to forge a new “deal” with him on health care. That’s not impossible, but it seems unlikely: it’s hard to think of a single major element of health reform where the Democrats agree with the president and the Republicans.
BillyBob Texas said:
The reason the dimwits public blames Trump and the “R’s” is that Trump and the ‘R’s” DO NOT use their bully pulpit to remind the dimwits who foisted this piece of crap on them.
Big Government AND 100% of the Dem’s – and 0% of the “R’s”. Keep saying it over and over again – like the Dems do.
But Ryan and his Be Nice Campaign is crap! Blame where blame derves to be – and unless the public is told – over and over again – they will end up believing the 100% Lying Dems.
Medex Man said:
Another moronic mass media opinion poll, sponsored and run by extremist liberals, claims to say that OBAMAcare is not a democrat problem? Same group that has been taking Soros’ rebellion money? Same group that was wrong on election, wrong on Brexit, wrong on Greece contagion being solved?
Same group of brainless twits who supposedly graduated from kindergarten and yet also believe they can get something for nothing (which is the underlying essence of Obamacare — its a scam underneath it all)?
Hopefully Paul Ryan and Nancy Pelosi will choke on each other’s man parts
And if there is any justice in the world, a lot of democratic enclaves will suffer serious health care system collapses. You people deserve it.
Medex man, please take your meds. Single payer health care costs half the corporate piece of shit the Demrats, Repugs, Pharma and Insurance companies installed. Mandated private insurance is does suck.
Kenneth Carroll said:
CVS no longer part of Blue Cross preferred pharmacy network; change impacts 390,000 Alabamians.
SNIP: Starting Jan. 1, the preferred pharmacy network of Prime Therapeutics, the benefit manager owned by Blue Cross of Alabama and 13 other BC/BS groups, does not include CVS. The change means a portion of Blue Cross insurance customers who use CVS pharmacies may pay a higher co-pay amount – or even the entire cost of the prescription.
This entire healthcare thing is miserable. Healthcare is by far my largest monthly expense (in Florida) for my family of 4 with no health issues. I am trapped in an old policy of which there is no current viable substitute. I have no way out, but to become unemployed (life altering situation as BCBS state) to get some cost relief while sacrificing coverage. This is absolutely insane for most of middle America. We definitely got the shaft from the Dem’s and many more will too moving forward without change we can actually believe in through proof, not lies.
Medex Man said:
How many decades have we heard (from both criminal parties) that Amtrak is going to be fixed?
How many decades have we heard the US Post Office is going to stop losing money every year?
How many f-cking morons still believe the US government can handle a far more complex system like health care? Only idiots believe the US government can ever run health care at anything close to a satisfactory level.
The VA system proves beyond any shadow of a doubt the federal government will just make things worse.
But there are “college educated” people in California (that is, they took gender equality studies and whined in “the quad” a lot) who actually think the federal government can run simple systems — while Sacramento can’t even run California. It takes a special kind of stupid to graduate from UC.
Root Hog Or Die said:
Ossqss, have you considered not having health insurance at all? I shattered my heel into a trillion pieces and as a cash customer getting cash discounts, it cost me $800 to fix. (No welfare of any kind, I paid cash on each visit.) Girlfriend got a hairline fracture in her ankle and her share of the cost after insurance was several thousand dollars. IMO, the whole idea of health insurance is fear-based marketing at its best.
Not an option with the IRS monitoring/forcing me and my small business to have it at this time. Besides, last time I modified my insurance and got rid of maternity coverage, my wife got pregnant the next month. That was an all cash process from then on, including an emergency C-section at the end. There went my new pick up truck………
Jon Sellers said:
The problem Obamacare attempted solve was to provide insurance for people who can’t afford it under normal circumstances in their lives. Who are these people? Mostly young folks who haven’t found full-time employment yet. And older folks who have pre-existing health problems or are low or no income.
The problem with providing it is that young folks won’t buy it because they are immortal, and insurance companies don’t want to pick up older folks who get sick a lot. How did Obamacare attempt to incentivize these players?
1. For the young, if you don’t join the pool, you have to pay a special tax.
2. For insurance companies, if your pool is especially top-heavy with the old and sick, the government paid you a special fee to be profitable.
Obamacare is collapsing because the government stopped ‘2’ above. The Republican Congress stopped appropriated funds to pay it a few years ago. Obama, illegally, just kept making the payments. Last year, Obama lost a court case so stopped being able to make the payment to the insurance companies.
That’s why the insurance companies are bailing. So the Republicans do totally own its collapse.
However, on a lighter note, the State of Alaska fixed it’s Obamacare problems buy paying its sole insurance company for the higher risk patients. In doing so, premiums actually went down, and other insurance companies are looking to join back in next year.
Tom Price is looking at Alaska as a model for the rest of the country.
Looking at the map Mish provided, why is it always the South getting screwed?
Medex Man said:
Obamacare promised something for nothing. It was a scam.
And you a-sholes in California aren’t paying your bills, your “health system” is running on IOUs you are unable to pay.
People in the south are able to count, do simple math, and balance a checkbook.
California, Chicago, Boston, New York — all run by people who majored in gender equality and failed at basic math
Lonesome Whistle said:
“the government paid you [the insurance companies covering older, sicker patients] a special fee to be profitable.”
They paid that fee OUT OF OUR INCOME TAXES AND BUSINESS.
It’s OUR MONEY, not the “governments” to give to insurance companies who then use some of their profits to hire lobbyists (former politicians) and to donate back to the Democrats!
The fighting back and forth is about who pays. For the providers there is conveniently zero focus on costs. Our costs per procedure is considerably higher than other first world nations. Until costs are address, HA never going to happen with the provider lobby, so the circle jerk of finger pointing will carry on and American’s will continue to get a free rectal exam
Stuki Moi said:
Anytime you have a “‘system”, or “program”, all you really have is a mechanism for entrenched interests to rent seek and hence charge more than they could in a true free-for-all-for-anybody (aka: a free society. That weird thing that was fashionable for a short while back when dead white males ruled) lack of “system.”
Of course, the same well connected intellectual light-to-no weights, that babbles about how “we” need immigrants to serve food and pick strawberries, and “free trade” to keep cell phones cheap and plentiful, lack the capacity for logical reasoning to realize the exact same argument is even more important in the fields comprising health care.
While the ever sicker and poorer idiot army, is kept busy worrying about some imaginary hobgoblin named Kim who The Man On TV says is almost as scary as one of those Moooslem Virgins.
WA state adopted similar health insurance scheme in the 1990s and the market went in a death spiral. Something to learn from…
It’s very simple, Mish. All those congressional copper heads have to do is increase the whippings at the IRS stake for brother Tom and sister Jemima’s failure to pick Blue Cross, instead of cotton, so Uncle Ken and Auntie Barbie can get their subsidized but expensive Obamacare plantation issued insurance, good only on the plantation, instead of cheap sear sucker cotton clothing made in India, so Master Merck can charge full boat for his drugs and patent medicine in Washington, and the state colonies, while giving those former Washington Tory loyalists in Canada cut rate prices. But hey, what do you expect when the new toilets for the international space station run nineteen million for multi cultural crapping off world.
Jon Sellers said:
Its amazing that the entire rest of the first world manages to cover their entire population for less than what the US spends to cover half. With better outcomes for the majority. The third world has affordable cash prices for most of the poor. $3 for a bottle of anti biotic from a pharmacist in Mexico, compared to hundreds or thousands here to visit a clinic or emergency room to get a prescription for the same bottle of pills.
The rich do get super care here. Rich people from around the world come here for care. However, the non rich can’t afford it. This creates a situation.
ALL health insurance should be banned.
That list is a who’s who of the worst US states run by Republicans.
ACA, Debt Ceiling, Syria,,,,,so many important issues. And to think, the “solution” to all of them will be decided with one critical factor in mind by CON-gress. The Mid Term Election. Bend over again.
The majority never change until they have to, and govt is 100 times worse, which is why we must crash and burn first. People should heed Denninger’s advise – http://market-ticker.org/akcs-www?post=231983.
I am so tired of this reading about this BS. F it. I hope Trump backs off and lets it all collapse. Obama created a monster and it’s grown so big we can’t kill it. Now it will eat us one by one. It’s fine time to eat our peas. I hope all you idiots who voted for Obama take a long hard look in the mirror!
Obama is not the only one owned by the healthcare industrial complex, which spends more on bribes (donations) than the banksters or military. ALL career politicians must be flushed every election to impose de facto term limits.
We’re discussing OBAMAcare. It was OBAMA and his DEMOCRAT following in congress that kicked OBAMAcare over the finish line.
Is crookery exclusive to Democrats and liberal politicians? Of course not.
But ACA has OBAMA’s name on it that was approved with Democrat votes.
If it has feathers, quacks and waddles – you call it a duck.
“Enrollment for 2018 starts in November. Will the problem be fixed by then? If not, What Happens if Places Have No Obamacare Insurers?”
Hardly an end of the world scenario. Inherently unworkable systems can only collapse, and cannot be fixed. The expected end result of Marxist Central Planning. Better to show patience as Obamacare proceeds to its logical demise in these states than for a guaranteed-to-fail USA.gov bailout labeled Trumpcare. Why give the Totalitarian Socialists and Democrats a big propaganda victory as reward for an idiotic scheme?
States can do like Oregon and Alaska, and create lifetime health care for people with costly chronic ailments. Oregon, Alaska and other states can become like Sweden and Germany are to immigrants. The sickest people in other states can vote with their feet, and move to states with the most generous (medical) freebies. Humanity will survive the absence of state-imposed mandates to buy expensive high-deductible health insurance policies. Not the end of the world, only the end of a mathematically-idiotic Central Planning folly.
Jon Sellers said:
Wouldn’t call this central planning. More just successful lobbying by healthcare companies.
All the states mentioned are Republican dumps. States are responsible for administering their own ACA markets. This is a failure of Republican governance more than anything, otherwise blue states would show up too. Republicans will do anything to avoid taking care of their own citizens.
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Stuki Moi said:
So, instead of, as per Newspeak, “letting more people” have health insurance, Obamacare does what all mandated “programs” do: Straight up ban people from selling health insurance to their neighbor. Such that their neighbor now can’t get insurance, period. How surprising….
But, of course, the idiot army will wait for the same expendables who told them this “program” was great, to come up with another “program.” Ad infinitum
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