A nonprofit publication of the Kentucky Center for Public Service Journalism

Rural Blog: All counties in the U.S. now have at least one option for private health insurance for 2018

Dozens of counties, mostly in rural areas, were at risk of having no individual private insurance options in 2018 after companies like Anthem Blue Cross and Blue Shield pulled out of the markets.

But a few insurance companies have filled gaps in coverage, and now there are no areas in the U.S. without coverage.

Paulding County, Ohio, was the last “bare” county until CareSource committed to offering coverage in 2018 to the 380 customers who need it, Dylan Scott reports for Vox. CareSource also filled coverage gaps for next year in other bare counties in Ohio and Indiana this summer.

This summer there were dozens of counties that had no individual insurance options for 2018. President Trump threatened not to pay insurers the federal cost-sharing payments that make it possible for them to offer low-cost plans to the poorest citizens.

Because of that and the general uncertainty surrounding Congressional Republicans’ fight to repeal and/or replace the Patient Protection and Affordable Care Act, some insurers decided it would be safer to withdraw from markets that depended heavily on federally subsidized plans. That left some areas with no coverage options.

But insurers like CareSource and Centene saw an opportunity in the bare coverage areas and have stepped in to fill the gap. Both are niche insurers that specialize in managing Medicaid programs for the poor.

“This isn’t a perfect solution, especially for people who don’t receive subsidies and therefore aren’t protected from premium increases in a monopolized market,” Scott writes. “It’s also possible that Trump does something in the next few weeks to disrupt the market again — insurers have until the end of September before they are truly locked into selling plans in 2018.”

Scott writes that the country should now focus on counties that have only one insurer in 2018. He’s not worried so much about insurers with monopolies charging outrageous prices, but more about customers not being able to shop around for plans that fit their needs.

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The Rural Blog is a digest of events, trends, issues, ideas and journalism from and about rural America, from the IRJCI, based at the University of Kentucky. The Institute for Rural Journalism and Community Issues is an extension program for rural journalists and news outlets. It takes no positions on issues and advocates only for strong news coverage, responsible commentary and things that make them possible, such as open-government laws. For more information see www.RuralJournalism.org.

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