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What to Do If Your County Only Has One Insurer

If you are one of the millions of Americans enrolled in an Obamacare health plan, then there is some good news and some bad news for you.  Depending on where you live, you could have only one insurer offering plans in your local health insurance marketplace. However, if you meet certain income criteria you may also be eligible for a Bronze tier health plan for zero dollars a month.

The number of insurers participating in the Obamacare exchanges has dropped, but every county in the nation will have at least one insurer offering plans in their region. Almost 30 percent of current Obamacare enrollees, however, will only have one insurer available to them. In total, 53 percent of U.S. counties, or 1,300 will only have one insurer, but because these are usually lower population, rural counties, a smaller portion of the population is affected by the reduced market.

For a large part of 2017, many health officials were concerned that some states would have no insurers at all.  State insurance boards worked hard to convince at least one insurer to participate in potentially “bare” counties, and by October, every U.S. county had been covered. Much of the lack of participation from insurers is due to the excessive cost of insuring new enrollees who tend to be much sicker than expected.

It has also been difficult to entice insurers to join the Obamacare exchanges since the Trump administration decided to discontinue cost-sharing subsidies. These subsidy payments to insurers help cover deductibles and out-of-pocket expenses on the lower cost health plans.  Without them, insurers have had to raise premiums on Obamacare health plans.

Free Bronze Tier Health Plans

A surprising outcome of the Trump administration’s refusal to continue cost-sharing subsidies is that the amount that many Obamacare enrollees get in tax credits has grown. Under the Affordable Care Act, if the premiums on exchange plans rise, then the government must compensate by increasing the amount enrollees get in tax credits to pay for premiums.

Because Obamacare enrollees may use the tax credits for any tier plan—Bronze, Silver, Gold or Platinum—in some counties, the tax credits are large enough to bring down the plan premiums on Bronze tier plans to nothing. Although the out-of-pocket expenses are higher on lower tier plans, for many people who don’t expect to go to the physician often, a free health plan should be perfect. Furthermore, by obtaining a health plan at low or no cost, policyholders avoid paying a fine for going uninsured.

Of course, you have to reside in a county where the lowest tier health plans are priced low enough.  According to the Kaiser Family Foundation, almost 60 percent of counties in the 39 states that use the website should have no-cost health plans. For many consumers, they should have a variety of no-cost plans to choose from. Also you must meet income eligibility criteria to qualify for the tax credits.

There are currently about 9 to 10 million Obamacare enrollees, but this number could increase substantially this year. As more people learn that there are no-cost health plans, more people are likely to sign up for them—potentially in huge numbers. Ultimately, the number of people who do take advantage of this opportunity will depend on how many learn that it is available.

If You Only Have One Insurer in Your Market

If you live in one of the almost 1,370 counties with only one insurer on your health insurance marketplace, you may be searching for options. If you stay with an Obamacare plan and you make less income than 400 percent of the federal poverty level—or about $97,000 for a family of four—you probably qualify for federal tax credits.  These tax credits typically amount to hundreds of dollars off of your premium each month, so it is usually in your best interest to stay on an Obamacare plan if you can.  This is especially true if you reside in a county where your tax credits are sufficient enough to completely cover the premium for a Bronze tier health plan.

If you plan on staying on your Obamacare policy or switching to one, be sure to do so during the Open Enrollment Period from Nov. 1 to Dec. 15.  This is the only time to shop and enroll in an Obamacare plan until the next Open Enrollment Period late in 2018.  If you need help finding the right policy for you, use the “Find Local Help” button on; you will be connected to local insurance agents and brokers to assist you.

Not everyone makes enough income to qualify for the Obamacare tax credits, so going with a marketplace plan may not be a wise choice.  If you make less than 125 percent of the federal poverty level, you may wish to look into enrolling in Medicaid.  Medicaid is another federal insurance program that serves primarily impoverished Americans.  Although funded by the U.S. government, Medicaid is administered by states, so each state has its own eligibility requirements.

Finally, there is the option of getting an insurance policy direct from a private insurer. Insurers offering health plans independent of the exchanges are usually very large with little real competition in small markets, so their prices may be quite high. If you are looking for a more cost effective health care plan, you should consult with a reputable insurance broker like Boost Health Insurance, that is independent of insurers.

When you are shopping for a health plan off of the exchanges, be sure to look closely at their benefits. Some states like Nebraska, Virginia and Iowa are permitting insurers to sell health plans that don’t include all of the benefits that Obamacare plans are required to include. Many of these plans are priced lower, but may only include catastrophic coverage.  If you suffer from a number of health conditions, it may be wiser to choose a more expensive plan with more benefits.

Medicaid Expansion



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