ACA “Bare Counties”: Policy Options to Ensure Access Must Address Longer-Term Stability and Competition

September 27th marks the day most insurers have to formally decide whether they’ll stay in the Affordable Care Act marketplaces in 2018. But continued uncertainty about federal funding for health plans has contributed to higher individual market premiums and insurer withdrawals in 2018. The danger that consumers in some regions wouldn’t have any coverage option next year seemed to subside when insurers in the affected states eventually agreed to broaden their participation. But that could change, once again, as insurers meet deadlines for committing to sell coverage in the marketplaces in 2018. At the same time, many more counties appear likely to have just one insurer offering marketplace coverage.

As policymakers debate proposals to “stabilize” the marketplace, the threat of counties with either no coverage option or just one plan to choose from deserves a response that considers not just the immediate effects of potential policy fixes, but also their longer-term consequences for access to affordable, comprehensive coverage.

In their latest blog post for The Commonwealth Fund, CHIR’s JoAnn Volk, Justin Giovannelli and Kevin Lucia consider proposals to ensure access to marketplace coverage. They find that solutions for bare counties that allow individuals to use upfront assistance to buy a fallback plan that offers comprehensive coverage would help those individuals who are affected buy and maintain comprehensive coverage while insuring healthy and competitive markets for all.

You can read the full blog post here.


Leave a Reply

Your email address will not be published. Required fields are marked *

The opinions expressed here are solely those of the individual blog post authors and do not represent the views of Georgetown University, the Center on Health Insurance Reforms, any organization that the author is affiliated with, or the opinions of any other author who publishes on this blog.