The repeal of the Obamacare individual mandate in the Senate's tax plan reportedly could derail insurance markets in conservative, rural areas that voted for President Donald Trump.
According to a Los Angeles Times analysis, the areas hardest hit would include most or all of Alaska, Iowa, Missouri, Nebraska, Nevada, and Wyoming — as well as southwestern Arizona, western Colorado, southern Mississippi, central North Carolina, and parts of Georgia, Virginia, and West Virginia.
There are 454 counties nationwide with only one health insurer on the marketplace in 2018, and where the cheapest plan available to a 40-year-old consumer costs at least $500 a month, according to the Times analysis, which was based on data from the nonprofit Kaiser Family Foundation.
"Repealing the individual mandate will affect insurance markets everywhere," Larry Levitt, a health insurance expert at the foundation, told the Times. "But markets where there is already little choice and high premiums are especially vulnerable. . . . Rural areas could be especially hard hit."
Eighty-six percent of these 454 at-risk counties have fewer than 50,000 residents, areas where healthcare costs are often higher; those counties also overwhelmingly supported Trump, the analysis found.
Insurance markets in those areas risk collapsing without the individual mandate because younger, healthier participants will opt out — and there will not be sustainable rates to care for older and sicker participants, the news outlets explained.
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