No Obamacare In Most Of Iowa, Tennessee - What Happens? Fallback Plans?

Tyler Durden's picture

Authored by Mike Shedlock via MishTalk.com,

Nearly the entire state of Tennessee has a single Obamacare provider. In sixteen counties, none of this year’s providers want to do business.

Mississippi, Alabama, South Carolina, Oklahoma, Alaska, and Wyoming are states where there is only a single provider for the entire state. Iowa is likely to be covered by a single provider next year. Most of North Carolina, Florida, Missouri, and Arizona are also in a single-provider situation.

Enrollment for 2018 starts in November. Will the problem be fixed by then? If not, What Happens if Places Have No Obamacare Insurers?

The markets created by the Affordable Care Act have always relied on the voluntary participation of private companies. If the government set up the right conditions for the market, the thinking went, insurers would want to jump in. But, as Sarah Kliff at Vox.com has reported, the law contained no real backup plan if that vision didn’t work out.

 

So far, there are parts of Tennessee where none of this year’s insurers want to sell insurance next year. Other counties have only one carrier, and in some of them, that carrier is looking shaky.

 

If insurers do all decide to exit a market, no one is exactly sure what will happen next. Some experts have brainstormed about possible workarounds, but all would entail uncharted legal territory.

 

Senator Lamar Alexander of Tennessee, the state currently at greatest risk of bare counties, has introduced a bill that would create options for customers shut out of their Obamacare market. But even if Congress passed such a law, regulators would have to work very fast to make anything happen before next year’s enrollment period, which begins in November.

No Backup Plan

Vox asks What if Obamacare Insurers Falls to Zero?

Multiple sources tell me that White House staff held a meeting today to discuss cost-sharing reduction subsidies — that $8 billion Obamacare program whose fate still hangs in limbo. Ending these payments could “blow up” the health law’s marketplaces, but President Trump has so far waffled on what he’ll do about the issue. The meeting didn’t include any outside advisers or industry officials, only administration staff.

 

Right now there are 16 counties in Tennessee where no health insurer wants to sell Obamacare coverage. Iowa could be next: Half its Obamacare insurers announced this month that they would no longer participate in the marketplace. That leaves 94 of the state’s 99 counties with just one insurer — and regulators there aren’t totally sure that plan, Medica, will stick around.

 

“We don’t have any commitment from the two carriers that remain that they will be there,” says Doug Ommen, Iowa’s insurance commissioner. “They’re not required to file with us until June. Certainly we’re hopeful, but unless Congress acts, our market will continue to be very unstable.”

 

What happens if no one wants to sell coverage? Does the law have any fallback plan? The short answer is no. There is no backup plan for places where no insurer wants to sell Obamacare coverage.

 

Even before the election, some big insurers had decided that the Obamacare marketplaces were not good for their bottom lines. Aetna and UnitedHealth mostly withdrew in 2016, leaving lots of places with just one insurer.

 

Since the election, health insurers have only gotten more skittish. Humana announced in February that it would no longer participate. That left those 16 Tennessee counties without any plans, and many more counties with just one option.

Ryan’s Folly

The articles mentioned that Trump could call up providers and bully them into offering coverage. But does that make any sense from a party that wants to Kill Obamacare?

The system is set up to implode and there is no point to doing anything until it does. After an implosion, there will be bipartisan support to do something. Right now there is no bipartisan support to do anything.

The folly of House Speaker Paul Ryan’s ill-fated attempt to fix the problem is readily apparent.

His poor decision to attempt to fix the unfixable accomplished nothing useful, but it did move partial ownership of the problem to Republicans.

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Silver Bullet's picture

All shithole, fat, red states. Big fucking surprise.

TeamDepends's picture

You don't own any silver bullets, do you?

GUS100CORRINA's picture

WHISKEY IS BETTER.

Wait till they pull the GSE funding in the BILLIONS. These are the FUNDS that the DEMOCRATIC PARTY and OBAMA illegally STOLE to support OBAMACARE.

What a tattered WEB we weave. 

Manthong's picture

Well, at least UnitedHealth has the NHS in Britain to go screw up now.

D Nyle's picture

since no republicans voted for Obamacare, Only Democrats should pay, for everyone

RAT005's picture

I have never paid the fine. It's not enforceable.  This year I was even able to file electronically simply by answering that it was too expensive.

amor terra's picture

The same.  I've been sure, each year, that I was going to be assessed the penalty and just refuse to pay it.  But each year, I answer the questions on the tax software truthfully, and each year, it says I'm exempt from the penalty.  Fact is, the cost of bronze plan "insurance" should be a hundred or less per person per month.  It's really lousy catastrophic health insurance that five years ago you would have paid $50-75/month for. 

There's a viable alternative, though.  Stop listening to ANYTHING that the medical establishment tells you, take care of yourself through good diet (basically nothing that is advertised and no sugar) and exercise, and live well.

 

 

MalteseFalcon's picture

Here's a simple fix.

In any county where the number of Obamacare providers is reduced to one, the entire ACA is ruled null and void.

Insurers can offer what they want, and consumers can choose their plan and doctor.

A market solution.

If you want your Obamacare, you can keep your Obamacare.

Twee Surgeon's picture

Forget about Health Care, it is a modern invention fantasy that lasted about 70 years. The British National Health service defined what such a thing might look like back in NineteenSixty Something. they killed it with Immigrants. Twas Paid in Full and worked quite well, THEY did not like that. Too many Whiteys surviving.

Before that little demonstration of Possibilities you were on your own with the Midwife and the Herbalist lady down the road and some Doctor guys pushing the envelope, few and far between.

Let us not forget the Black Death and the Spanish Flu of 1918, indiscriminate biological agents that have wreaked havoc then and some will, again.

https://en.wikipedia.org/wiki/Black_Death       https://en.wikipedia.org/wiki/1918_flu_pandemic

This stuff has not gone away, it is just very patient and hiding just outside the City Walls.

 

Manthong's picture

Well, at least UnitedHealth has the NHS in Britain to go screw up now.

How do you say “Bring out your dead” in Arabic?

https://www.youtube.com/watch?v=grbSQ6O6kbs

Rusty Shorts's picture
“Let food be thy medicine and medicine be thy food.” - Hippocrates
RAT005's picture

And enough rest and exercise.

RAT005's picture

And enough rest and exercise.

JungleCat's picture

So how do you explain e.g. Kansas and Arkansas, which are also red states.

Why do counties in those stated not have a single insurer?

Hail Spode's picture

I can speak for Arkanas- their program is a scam which benefits insurers. Medicaid recipients were folded into the exchanges with the average Medicaid budget converted into premiums for insurers. Then the state signed up everyone they could, including auto-enrolling whoever was in certain state programs, and then resisted checking eligibility for as long as they could. People from every state were enrolled in AR Medicaid program. Dead people were enrolled. People who went back to Mexico were enrolled. People who later got jobs that had insurance plans were still enrolled. And for all of them, Uncle Sugar was still paying premiums to AR insurers, with the state collecting what amounted to a "sales tax" on each fradulent plan. So that is why AR has more than one provider- the ruling class of Arkansas (R and D) is colluding with AR insurers to defraud the federal government on a massive scale.

BrownCoat's picture

@ Silver Bullet,

Ya missed the point, comrade. Obamacare does not work!

Handful of Dust's picture

The Democrats, lead by Bolshviks Obama, Pelosi and Reed, forced Obamacare onto hard working Americans and crushed the middle class. Not only is the middle class broke now, but they have no realistic access to affordable care anymore.

 

Open the system and let people make their own choice what plan/coverage they want and with the insurer of their choice. NEVER force Americans into shit like this again.

crossroaddemon's picture

Nope... this is where single payer gets rolled out, and all the people who would have protested the fuck out of it a decade ago will be begging for it. That was the plan right from the start.

uhland62's picture

That will never fly because this and every other solution which means premiums aren't sky high require some form of subsidisation, cross subsidisation.

This is rejected by almost everyone. You cannot lift wages to a level that carry the the genuine costs of health insurance. Insurance means 'you pay my damage today and I pay your damage tomorrow'. Since nobody wants to pay today, there will be no health care for those who cannot pay the genuine premiums. 

Single payer means keeping a cap on costs. That is regulation and also rejected. The topic is done; they ought to do something productive.  

rlm1966's picture

You mean like patent reform so changing one molecule that is inactive, locks a drug up for another 7 years, or why it one lower price for insurances companies and a much higher price (for care) if you are paying cash.  Maybe, just maybe, FDA testing of drugs should be much cheaper and not involve corporate sponsership.  So much they could do to start righting the ship and they won't do a damn thing.

AGuy's picture

"ou cannot lift wages to a level that carry the the genuine costs of health insurance. Insurance means 'you pay my damage today and I pay your damage tomorrow'."

That why nations with Single Payer systems use waiting lists. Need Surgery, Its a five year wait. Broken Arm: six Month wait.

"ince nobody wants to pay today, there will be no health care for those who cannot pay the genuine premiums. "

No Healthcare even if you pay the premiums due to the $6K+ deductables. You end up shelling out $10K+ before insurance kicks in a dime, and when your Medical bills exceed the premiums you paid + the deductable, they raise you premiums.

The only ones who make out are the people below the poverty line. If you make less than $18K you just go to the emergency room and all your bills are paid. Thats were the money is going.

If you have insurance, you also need to pay your deductable up front before they will help you. Hospitals have been getting burned by patients that have health-insurance but cannot cover the deductible.

Realistically the only reasonable option is to find a medical provider that excepts cash and will offer a reasonable price. Going the insurance way and playing by the rules is going to rob you.

DaveA's picture

"The only ones who make out are the people below the poverty line."

In that case, middle-class people need only pretend to be poor and not pay their hospital bills, and they get off scot-free.

The current system is an honor system -- it depends on middle-class people feeling honor-bound to pay all their debts. But if someone else decides how much you owe when it's too late to back out of the deal, "honor" is another word for bending over and biting the pillow.

If we all canceled our insurance and tossed our medical bills in the trash, doctors and hospitals would be forced to demand payment up front and cater to paying customers, while making indigents wait outside in the rain.

AGuy's picture

"In that case, middle-class people need only pretend to be poor and not pay their hospital bills, and they get off scot-free."

Hospital do a credit check on patients. You cannot simply prentend to be poor.

DaveA's picture

Hospitals can't touch your primary residence, nor can they take your car. And if they could seize bank accounts, the banks would be out of business because no one would put money in them.

They don't make a serious effort to collect unpaid bills or settle them for reasonable prices (e.g. 3x what their services cost in other countries instead of 40x), they just charge higher prices to patients who have insurance.

It's hard to get rich, hard to stay rich, and easy to get poor. (I'm not saying it's easy to *be* poor -- that depends what benefits are on tap in your jurisdiction, and how much cash you're hiding off the books.)

The Wedge's picture

"The only ones who make out are the people below the poverty line".

Not the case at all if you are single.

FringeImaginigs's picture

Single payer?  What are you a pinko commie socialist fucking nazi pinko. You want to steal ideas from all the European countries that have single payer? Yes sure they pay less than we do for better care but what about free markets and the profits of hospitals, docs and drug companies. Have you thought that through? This is the land of the free and the home of the scam.  If you want single payer than why don't you claim refugee status in Canada? 

The Wedge's picture

That's right or partially right. Many haven't figured out that we have already been screwed hard with no lube. We will get single payer and there will be idiots cheering for it all the way to shitsville. They have screwed us long ago and there will be no backing out of this. Thanks to years and years of horrible gov policy the only choice left will be single payer. The sky rocketing cost of health care is a boon for the monetary system and hand selected corporations. Is this not great!!! It's fucking awesome when gov shoves their cock down your throat.

SokPOTUS's picture

What will happen if there are zero insurers in a county? Well, for starters, 100% of that county's residents would be subject to the Obamacare Tax Refund Looting Penalty.

Beautiful.

Could Congress go 435 R to Zero D in 2018?

Scuba Steve's picture

Heard about  Berkley and NY safe spaces lately?

Not a fukkin chance of congress going 435 R ... the low-rent, taker sheep deserve to die a slow painful death of starving, penniless.

If family wont take care of them ... Fukk'em, thats where we are headed in a timely fashion.

Alananda's picture

Here "We the People" have a wonderful opportunity -- take back "health care", "disease treatment", "disease prevention" [tell the CDC and FDA to get the hell outta Dodge (so to write) with their poisonous vaccines].

Let the system fail. Do not go back for "moar". Plug in to those who truly know "health", "well being", and "healing".

Tons of electrons out there willing to inform you.

WillyGroper's picture

"[tell the CDC and FDA to get the hell outta Dodge (so to write) with their poisonous vaccines]."

i'm afraid they have something else in store for us.

http://www.naturalnews.com/2017-04-18-alert-135-pro-vaccine-bills-are-active-in-35-states.html

 

now to make things worse, i know a young'n in the 2nd grade.  wifi abounds in the school.  the teacher is saying he's too hyperactive, can't sit still & has been making videos of him.  you know they'll be drugging him next.  he's not hyper at all in my house, which is a faraday.  all these kids they're putting on these drugs have nervous systems being fried by emf.

heaven help us from these monsters.

milo_hoffman's picture

EASIEST way to get rid of Obamacare.  DO NOTHING. 

It will die of its own weight. 

 

And all the while just keep blaming the Democrats over and over and over.

OccamsCrazor's picture

Obama's only plan from the start was to royally fuck people, and make them go for single payer, government sponsored sick carelessness. 

12 month wait for surgeries.

6 month wait for cancer treatments.

3 month wait for ER visits.

1 month wait for getting a sponge massage from a nurse.

0 month wait to take $1000's of dollars from you for the privelege of being screwed. 

directaction's picture

In cities near the border with Mexico one will find modern medical centers staffed by US-educated doctors.
Good ones. They charge about 10% of what medical care in the USA is.  
Bring cash for a bigger discount. No waiting for anything. Cheaper drugs, too.  

FringeImaginigs's picture

And in the country just north the citizens get "free" health care. All of them! No preconditions, no premiums, no refusals. It's just part of what the society decided to pay for. And their costs are half of ours. 

rlm1966's picture

Why is it mandated for people to buy, but not mandated for people to sell.  Only seems fair to me.  

 

Let it burn.

SokPOTUS's picture

Because both are Unconstitutional Fascism.

strayaway's picture

Many supporters of Obamacare probably believed that it was going to work. Obama broke the rules to foster its survival. As Hayek wrote, when faced with failures, planners respond by further subsidizing their failure and suppresing criticism. Let the blue states subsidize Obamacare or otherise set up their own health care plans. At least the latter would be consistent with the 10th. Amendment.

Vermont did try to set up its own 'affordable' single payer plan under Obama but Obamacare thugs would only allow such a thing if it included all of Obamacare at its core making Vermont's proposed plan unadffordable. Vermont gave up. Now that Vermont, California, etc. have an opportunity to replace Obamacare with the single payer plan they claim to prefer, they are silent. Just as Republicans who always supported ending Obamacare as long as Obama could veto their efforts to do so, Democrats prefer a failing Obamacare to workable state single payer plans. Both parties are priobably beholden to status quo campaign contributors.

 

 

strayaway's picture

Many supporters of Obamacare probably believed that it was going to work. Obama broke the rules to foster its survival. As Hayek wrote, when faced with failures, planners respond by further subsidizing their failure and suppresing criticism. Let the blue states subsidize Obamacare or otherise set up their own health care plans. At least the latter would be consistent with the 10th. Amendment.

Vermont did try to set up its own 'affordable' single payer plan under Obama but Obamacare thugs would only allow such a thing if it included all of Obamacare at its core making Vermont's proposed plan unadffordable. Vermont gave up. Now that Vermont, California, etc. have an opportunity to replace Obamacare with the single payer plan they claim to prefer, they are silent. Just as Republicans who always supported ending Obamacare as long as Obama could veto their efforts to do so, Democrats prefer a failing Obamacare to workable state single payer plans. Both parties are priobably beholden to status quo campaign contributors.

 

 

strayaway's picture

Many supporters of Obamacare probably believed that it was going to work. Obama broke the rules to foster its survival. As Hayek wrote, when faced with failures, planners respond by further subsidizing their failure and suppresing criticism. Let the blue states subsidize Obamacare or otherise set up their own health care plans. At least the latter would be consistent with the 10th. Amendment.

Vermont did try to set up its own 'affordable' single payer plan under Obama but Obamacare thugs would only allow such a thing if it included all of Obamacare at its core making Vermont's proposed plan unadffordable. Vermont gave up. Now that Vermont, California, etc. have an opportunity to replace Obamacare with the single payer plan they claim to prefer, they are silent. Just as Republicans who always supported ending Obamacare as long as Obama could veto their efforts to do so, Democrats prefer a failing Obamacare to workable state single payer plans. Both parties are priobably beholden to status quo campaign contributors.

 

 

strayaway's picture

Many supporters of Obamacare probably believed that it was going to work. Obama broke the rules to foster its survival. As Hayek wrote, when faced with failures, planners respond by further subsidizing their failure and suppresing criticism. Let the blue states subsidize Obamacare or otherise set up their own health care plans. At least the latter would be consistent with the 10th. Amendment.

Vermont did try to set up its own 'affordable' single payer plan under Obama but Obamacare thugs would only allow such a thing if it included all of Obamacare at its core making Vermont's proposed plan unadffordable. Vermont gave up. Now that Vermont, California, etc. have an opportunity to replace Obamacare with the single payer plan they claim to prefer, they are silent. Just as Republicans who always supported ending Obamacare as long as Obama could veto their efforts to do so, Democrats prefer a failing Obamacare to workable state single payer plans. Both parties are priobably beholden to status quo campaign contributors.

 

 

Fourth Horseman's picture

Before Niggercare, I had a great PPO.

After niggercare, I have the bottom bracket shit insurance for the same price. Fuck that NIGGER O'nigger Repeal this turd NOW!

VegasBob's picture

The purpose of insurance is to cover a risk before the risk event occurs.  For example, no insurer will sell you a fire insurance policy AFTER your house has already burned down.  Nor will any insurer sell you an UNLIMITED insurance policy on your house.

The main flaws of Obummercare are that it got rid of the pre-existing condition model and it got rid of maximum limits on how much a health insurance policy would pay out.

It would have made much more sense for government to require insurance companies to price policies that did cover preexisting conditions and then heavily subsidize such policies for those who could not afford them.

I personally am a good example.  I'm terminally ill with cancer, which was diagnosed AFTER I'd already had health insurance for 2-1/2 years.  In that situation, the insurance company should pay up.  However, I will turn 65 later this year (if I live that long), and then go on Medicare.  The cancer drugs that keep me alive cost $25-30K a month.  I'll take the coverage from Medicare since it probably beats dying, but I'm not sure that's the morally appropriate course of action, since I already had the cancer when I became Medicare-eligible.

My situation also explains why Medicare is ultimately going to go broke.  If I live for a year on Medicare, it will cost the government $300-360K.  The simple reality is that people like me are going to break the Medicare bank.

Bear's picture

Sorry to hear VB ... you've been here a long time

space junk's picture

Sorry to hear.  The whole thing, just like the entire IRS tax code, is a fraud. 

No one should ever feel bad about anything that helps offset the massive codified fraud.  I felt that way 20 years ago, but most especially now when the unaffordable careless act is ruining so much. It's textbook stories of unaffordability.  They not only crap in our hand but we are supposed to all act like it's chocolate?  Not me. 

This country should never have let them play with the economic principles in the name of pretend-fairness, any more than we should hand our 16 year old sons a couple of cases of whiskey and keys to the car. 

God Bless America!