There's one state where Obamacare is 'very near collapse'

Tennessee's Obamacare market is in serious trouble, according to the person who runs the state's exchanges.

Julie Mix McPeak, the Commissioner for Tennessee's Department of Commerce and Insurance, told Nashville's The Tennessean on Tuesday that increases in premium prices and the dwindling number of insurers in the state are causing serious stress in the state's Affordable Care Act exchanges.

"I would characterize the exchange market in Tennessee as very near collapse... and that all of our efforts are really focused on making sure we have as many writers in the areas as possible, knowing that might be one," said McPeak in an interview with The Tennessean's Holly Fletcher.

"I'm doing everything I can to prevent a situation where that turns to zero."

Part of Tennessee have seen the number of insurers offering plans drop significantly, with four of the state's eight exchange rating regions having one or fewer choices for insurance companies according to an analysis from healthcare consulting firm Avalere.

McPeak is trying to avoid something similar to what is happening in Pinal County, Arizona. After health insurance giant Aetna decided to leave the county, it has been left with zero insurers offering plans on the county's ACA exchange. In Pinal County's case, many people who rely on subsidized Obamacare may be left without insurance entirely.

Like many insurers across the country, those offering plans in Tennessee are losing serious amounts of money on the exchanges, leading to significant premium increases for patients and substantial losses for insurers.

According to the Tennessean, Blue Cross Blue Shield of Tennesse (BCBST) - the only insurer to offer plans statewide - has lost roughly $500 million from the states' exchanges in the three years since it entered them.

Essentially, the people signing up for insurance in the exchanges like Tennessee have been sicker and more expensive to cover than health insurance companies predicted, leading to large losses.

To avoid these losses, many insurance companies have increased prices dramatically in the state, with BCBST requesting a 62% increase for premiums in 2017 after a 36.3% hike in 2016. Both "big five" insurers that do business in the state, Humana and Cigna, are also requesting premium increases of over 20% for next year.

While regulators told The Tennessean that they plan to use a number of tax breaks and other strategies to keep patients' monthly costs from skyrocketing in the state, the huge jumps in the requested headline premiums are hard to ignore.

Of note, requests must be approved by McPeak's office at the Department of Commerce and Insurance, so the numbers for 2017 are just projections.

While many states face challenges, based on the comments by McPeak, the situation seems to be dire in Tennessee.

Read the full breakdown of Tennessee's situation at The Tennessean»