ALL U.S. COUNTIES WILL BE COVERED BY ACA PLAN

Remember Republican politicians saying (with a sad look on face) that they will have so many counties that won't be covered by the ACA in 2018?

As many as 82 counties in states such as Tennessee, Nevada, Indiana, Missouri, Wisconsin and Washington had appeared at risk of lacking any exchange coverage in 2018 after expected withdrawals by insurers, according to a tally by the Kaiser Family Foundation. * 

Well now that it looks like the ACA will live for another year, magically all counties in the U.S. will be covered by ACA.

For awhile there was one hold out - Paulding Co. in Ohio - but now even that is covered.  Oh the embarrassment of it all, being the ONLY counyt in the U.S. not to have heath care insurance.  What can the health be like in such a county to deserve that?   Does everyone have a pre-existing condition or what?

CareSource’s chief executive, Pamela Morris, said the decision “was the right thing to do as a mission-driven company.” CareSource was able to agree to offer exchange plans in Paulding County because it has a presence in a neighboring county in the adjacent state of Indiana and thus has a network of health-care providers there. Ms. Morris said CareSource, which offers exchange plans in four states, was “fully committed” to those marketplaces, despite uncertainty about federal decisions related to the health-law marketplaces.*

At any rate, the hero of the moment is a non-profit health  insurance company called CareSource.  Another company - Centene Corp. - has covered Nevada

Then the Republican politicians claim that so so-many counties have just one insurer.  Heck, here in North Carolina we have had just one insurer since the git go.  After alo, the state refused to construct its own plan and left it up to the Federal government.

The Robert Wood Johnson Foundation estimates that 1,448 counties now appear likely to have just one exchange insurer—nearly half of all U.S. counties—while another 1,013 are projected to have two. According to the Kaiser Family Foundation, this year, 1,021 counties had one exchange insurer, while the figure was 225 in 2016. The counties with fewer insurers tend to be largely rural.

The expected shifts for next year also continue trends that have emerged over time in what types of companies are committing to the exchanges. Medicaid-focused insurers such as CareSource and Centene, which is planning to expand its marketplace offerings and has agreed to help fill bare counties in Missouri, as well as Nevada and other states, are increasingly central to many states’ exchanges. Blue Cross Blue Shield plans also remain the backbone of many states’ exchanges*.

Naturally if you leave it up to the insurance companies, they will try to limit competition so they have divided up the country to their advantage with each company having a monopoly in each state not covered by the state.  Its called "having a moat" or "high barrier to entry." and not the nasty word monopoly.

* https://www.wsj.com/articles/ohio-county-gets-affordable-care-act-coverage-ending-risk-of-marketplace-gap-1503591859