Rural US to become “insurance desert,” 650 counties to have one insurer on exchanges

Rural US to become “insurance desert,” 650 counties to have one insurer on exchanges

Rural US to become “insurance desert,” 650 counties to have one insurer on exchanges Health insurance agents in the rural United States could soon be faced with an "insurance desert" as carriers continue to pull out of certain regions of the country.
A recent report from the Kaiser Family Foundation shows that as many as two states and 650 counties are on track to have just one insurer on the Affordable Care Act exchanges next year. The entire states of Alaska and Alabama will be faced with just one choice in 2017, as well as large swaths of Kentucky, Tennessee, Mississippi, Arizona and Oklahoma.
That’s up significantly from 225 counties with just one marketplace competitor in 2016.
Insurer withdrawals are largely affecting rural areas, Cynthia Cox of the Kaiser Family Foundation said. In fact, 70% of the counties facing a lack of options next year are mostly rural.
And that number could even grow; filings in many states aren’t public yet, and insurers are free to change and update their offerings until September.
The crisis has been triggered as health insurance companies continue to face losses greater than planned. Cutting out rural areas is an easy way to stave off some of that, as rural area enrollees tend to have significantly higher medical costs than enrollees in urban areas. Rural healthcare providers also charge more, a new analysis from health technology firm Inovalon Inc. shows.
"Individuals in less populated areas tend to be sicker," Inovalon executive April Todd told the Wall Street Journal.
Withdrawing from these areas is not going to make insuring residents any less expensive, however. In fact, with fewer competitors, rates are likely to go up.
According to a study published last year in the American Journal of Health Economics, having more insurance carriers on the ACA exchanges brought down the end price for consumers. In light of that fact, regulators say they are worried.
"When there’s more competition, consumers typically are better off," Mark Fowler, chief of staff at the Alabama Department of Insurance, told the Journal.
Blue Cross Blue Shield plans are typically the only option for residents in the affected counties, though Aetna has signaled its interest in expanding its presence in certain areas as the ACA markets stabilize.
 "[We have] preserved our options to enter certain new geographies pending careful evaluation of marketplace conditions," said Aetna spokesman T.J. Crawford. "We have not made any final decisions on where we might enter new Affordable Care Act states."
  • Vincent Daly 5/17/2016 12:58:55 PM
    As usual with government interference in the market place the poorest areas are getting hurt the most. Thanks Obama.
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  • Jim Ezersky 5/17/2016 3:21:16 PM

    But, if you like your insurance company, you can keep it, right? (ha.) As this nightmare of the PPACA keeps moving toward the cliff, we all need to take stock of the age old pattern we're experiencing.

    Politically, a government takeover starts when some politicians demonize those companies in private business for not being all things to all people. Then, enter laws like this with overwhelmingly complex and burdensome requirements.

    These destroy competition, the very foundation of efficiency in private markets. Companies leave in droves, consumer choice is destroyed, and cancerous regulations grow into Soviet Union style bureaucracies.

    It's all about power, basically, and power is shifted away from private businesses and into government offices, staffed with political and bureaucratic zealots who are brainwashed into thinking they're empowered with redefining something so far reaching as our own personal health care.

    If successful, one sixth of our entire economy will fall under the complete control of these government employees and away from the patients and providers.

    Costs skyrocket, due to massive regulations and health care is rationed, and the sick and desperate are left begging bureaucrats for permission to get medical care that we used to take for granted.

    Country after country, this is "rinse and repeat:" two levels of care evolve, though, the "free" care that we've been brainwashed into thinking is high quality, and "private pay" where the wealthy pay membership fees and prompt, needed care out of their own pockets.

    Unless this thing is blown up and markets reestablished, this is our future of health care. It means nothing to you until you need serious health care, then it's everything to you.

    Ahh, but it's for the good of society; right, Comrades? Fines, penalties, and confusion.

    It wasn't that long ago that my State had several hundred health insurance carriers and a mind boggling array of choices at truly affordable prices. They sure didn't leave the industry because they were making too much money.

    Rebuild the private market, subsidize the State-created High Risk Pools for last resort insureds and blow up this federal nightmare before it owns us all. It failed: PERIOD.
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  • Randy A 8/17/2016 12:34:36 AM
    Medicare for all would take care of this - the public option!
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