Counties at Risk of Having No Insurer on the Marketplace (Exchange) in 2018

The map below shows the counties at risk of having no insurer on the marketplace (exchange) in 2018, as of September 15, 2017.

The map is based on a Kaiser Family Foundation analysis of insurer rate filings and news reports. Our historical analysis of insurer participation on the marketplaces from 2014-2017 can be found here.

These data are preliminary and subject to change as more information becomes public. Insurer participation in 2018 will not be finalized until the fall of 2017. It is possible that another insurer will expand into the counties that currently appear bare, and it is also possible that insurers will exit from other counties not shown on this map.

If a county has no exchange insurer, consumers would not be able to purchase marketplace plans with federal subsidies, including advanced premium tax credits (APTCs) and cost-sharing reductions (CSR). Tax credits make coverage more affordable throughout the year by lowering consumers’ monthly premium costs; cost-sharing reductions help lower out-of-pocket costs. In 2017, 8.7 million people (84% of all marketplace enrollees) received tax credits to cover a share of their premium and 5.9 million people (57% of all marketplace enrollees) received cost-sharing reductions.

This map only shows participation by on-exchange insurers. It is possible that some people in counties with no exchange insurers in 2018 will be able to purchase individual plans off-exchange, though this coverage would not qualify for financial assistance. If no exchange insurer participates in their county, people that rely on these subsidies may be unable to afford insurance off-exchange.

The below map shows counties that have been at risk of having no exchange insurer in 2018 at some point since February 2017. In many of these counties, at least one insurer has since announced that they will cover the county in 2018. The map text explains when these counties were considered at risk of having no 2018 exchange insurer, and which insurers have since announced they will cover the counties in 2018.

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