One of the last remaining insurers in Missouri participating in the ObamaCare exchanges pulled out. This leaves 19,000 Obamacare enrollees in 25 counties in that state with no options in 2018. TIP: See a visual of this from VOX, Another Obamacare insurer just quit, leaving 25 Missouri counties with no options.
Now 1 region has 0 insurers, another has 1 insurer, and another has 2.
This is an effect of several different factors. These include two that are focused on Republicans specifically:
- In “red” states that rejected ObamaCare in general and Medicaid expansion specifically, especially in rural areas, there has been a general effect of ObamaCare not working as well as it does other places.
- In a state that has Medicaid expansion and lots of insurers competing, no one insurer is stuck with all the sick patients. Meanwhile, when you are the last insurer in Missouri, and your state just voted down Medicaid expansion, the insurer is all but guaranteed to lose money. See: Missouri House Votes Down Medicaid Expansion. The insurer pulling out and the rejection of Medicaid expansion are very likely related.
The blame starts and ends with the Republican strategy to “break ObamaCare.” Had they not tried to send it into a death spiral, there would be less of a spiral. Consider, this is not happening in “blue states” that embraced ObamaCare for the most part.
Of course, this isn’t just red team vs. blue team politics here; there is more going on.
Other problems include:
- A problem with rural states is that they don’t have the healthcare provider networks they need.
- The general problem of raising premiums, mandated benefits, and subsidization is that, for all the moral good tax credits do, they also distort markets.
So, for example, if you have a rural state, led by GOP, without the providers, who rejected Medicaid expansion and who are part of the “break ObamaCare” strategy, you you create conditions that lead to insurers pulling out. This is a problem and not just a red team problem. One can’t help but be a little frustrated on many levels here.
5 States Will Have Only 1 Obamacare Insurance Provider today. These are all states that fit this mold: Alabama, Alaska, Oklahoma, South Carolina and Wyoming. Now Missouri is close.