Obamacare’s Bare County Problem Looks Mostly Solved, for Now
A few months ago, it looked as if large swaths of the country might end up without any insurers willing to sell Obamacare insurance in 2018. But in the last few weeks the “bare county” problem, which President Trump had cited as a sign the markets were failing, has nearly solved itself.
On Tuesday, Gov. Brian Sandoval of Nevada announced that Centene would offer insurance in 14 rural counties of Nevada that had been bare. That leaves only two counties in the country without insurers saying they will sell coverage; fewer than 400 Obamacare customers live in those counties.
The bare county problem had been a sort of unplanned policy hole in Obamacare, which depends on private companies to provide insurance to people who don’t get coverage through a government program or work. The federal government provides subsidies on a sliding scale to help middle-income Americans pay their premiums, but it doesn’t do anything to force insurers to offer coverage if they don’t want to. For a while, it seemed there would be a smattering of mostly rural places in the country where no company saw a reason to participate in 2018.