What would happen to a state exchange with no insurers?

By Annette Boyle

With three rural states poised to have just one health insurer participating in their Affordable Care Act exchanges next year, it's worth asking what would happen if in the future some states ended up with no carriers on their exchanges, according to Vox.

The Alaska, Alabama and Wyoming exchanges will have just one insurer in 2017, the article notes. In all, 650 rural counties across the country that will have only one marketplace insurance option on next year, in part because major insurers UnitedHealth and Humana are both exiting some exchanges.

In such a situation, there appears to be no real contingency plan, Caroline Pearson, senior vice president of Avalere Health, tells Vox.

However, such an open market could appeal to insurers. In 2013, it looked as though 36 counties in Mississippi would have no ACA options, but Humana stepped in shortly before the exchanges opened and offered coverage--at some of the highest price points in the nation, according to the article. The opportunity to make a significant profit could attract an insurer to other markets that have no competition.

For consumers, that may mean insurance remains available, but with higher premiums. Studies have shown greater competition in ACA marketplaces generally translates to lower premiums.

For example, Blue Cross Blue Shield, the sole insurer in Alabama, Alaska and Wyoming, has announced sharp price increases for next year in those markets, according to the article.

For more:
- read the Vox article

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