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One of the biggest fears about the future of Obamacare was just eliminated

Aug 24, 2017, 22:20 IST

Mark Wilson/Getty Images

The last potentially empty county on the Affordable Care Act's insurance exchanges has landed on an insurer, the Ohio Department of Insurance said Thursday.

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CareSource, an Ohio-based insurer with a background in Medicaid, will offer plans on the Obamacare individual insurance exchange in Paulding County, which was the last remaining county in danger of having no insurer in next year's marketplace.

The prospect of empty counties has long been a serious concern of health policy experts, since there was no back-up plan for those with coverage if counties went bare. Overall, 334 people had signed up for 2017 Obamacare plans in Paulding County.

"There is a lot of uncertainty facing consumers when it comes to health insurance and these announcements will provide important relief," Ohio Department of Insurance Director Jillian Froment said in a statement Thursday.

Cynthia Cox, an associate director at the Kaiser Family Foundation, a nonpartisan health policy think tank, said the concern was exacerbated in rural counties like Paulding because of the exit of Anthem and other Blue Cross Blue Shield providers.

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"The majority of these counties were at risk of being bare at least in part because Anthem or the state's Blue Cross Blue Shield plan left the market," Cox told Business Insider in an email. "These exits raised the question as to whether any company would have the ability or desire to come in and cover these counties. Not every insurer has a statewide provider network in place, and a lot of these counties are rural."

Many of the recent insurers that have stepped into bare counties in places like Nevada, Wisconsin, and Indiana over the past two months, Cox said, have been Medicaid-focused companies like Centene and CareSource that have experience serving populations that are more similar to exchange participants.

"At the end of the day, this is a business decision, and it appears Centene and several other companies see this market as profitable," Cox said. "First-quarter insurer financial data suggests that companies in the individual market are on a path to be profitable this year."

At different times earlier this year, states like Kansas, Tennessee, and Washington also were in danger of having bare counties, but eventually saw them filled.

Since President Donald Trump took office, the Department of Health and Human Services and Republican politicians consistently cited the number of bare counties as an example of the failure of Obamacare exchanges.

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For Cox, however, this was an example of their deficiency - but also their resiliency.

"The exchange markets have not been without problems, but they aren't collapsing," Cox said.

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