At least 36,000 Obamacare enrollees may have no health plans in their exchanges in 2018.
An analysis of projected insurer participation in the Affordable Care Act health insurance exchanges in 2018 released by the Department of Health and Human Services showed 49 counties without coverage as of June 27.
The situation could change as insurers have until Sept. 27 to submit final signed agreements to participate in the exchanges.
But the numbers of bare counties are rising. An analysis done by the HHS June 9 found 47 counties with 35,000 exchange enrollees without coverage.
Moreover, as many as 1,300 counties, more than 40 percent of counties nationwide, could have only one issuer in 2018. That could impact as many as 2.4 million exchange participants, the HHS said.
The number of insurers participating in the exchanges has declined since they were opened in 2014 due to heavy losses covering a population that has proved to be older and sicker than expected.
And premiums are continuing to rise at a fast clip. After an average 25 percent increase in 2017, early indications are that 2018 premiums will also far outpace inflation. Avalere Health found initial 2018 premium proposals for the most popular silver-tier exchange plans were up 18 percent in eight states compared with 2017.
Republicans in Congress and President Donald Trump are trying to replace major parts of the ACA with legislation that would lower premiums and give states more power over health insurance markets.
About 12.2 consumers enrolled in the ACA marketplaces during the 2017 open enrollment period that ended Jan. 31, the HHS reported.
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