The major concern for the 2018 enrollment period in the Affordable Care Act (now that it's clear that a Republican House, Senate, and White House cannot unite to repeal it) has been the problem of the uncertainty Republicans created which led to lots of insurers deciding to pull out of the markets. That was potentially leaving dozens of counties around the country "bare," with no insurer in the marketplace. That's been almost entirely resolved now, with other insurers stepping up to fill the void in all but two counties.
On Tuesday, Gov. Brian Sandoval of Nevada announced that Centene would offer insurance in 14 rural counties of Nevada that had been bare. That leaves only two counties in the country without insurers saying they will sell coverage; fewer than 400 Obamacare customers live in those counties.
The bare county problem had been a sort of unplanned policy hole in Obamacare, which depends on private companies to provide insurance to people who don’t get coverage through a government program or work. The federal government provides subsidies on a sliding scale to help middle-income Americans pay their premiums, but it doesn’t do anything to force insurers to offer coverage if they don’t want to. For a while, it seemed there would be a smattering of mostly rural places in the country where no company saw a reason to participate in 2018. […]
Mr. Trump, who has been pointing to Obamacare’s weaknesses in attempts to marshal support for a health care overhaul, began seizing on the bare counties, frequently noting that Obamacare was set to “implode.” Republicans in Congress also often made note of the bare spots. The Centers for Medicare and Medicaid Services, the government agency that runs the marketplaces, has been periodically updating a map of insurer moves, marking potential bare counties in red.
But then, just as some insurers exited Obamacare markets, others began entering to fill the holes left behind. Centene, a company that has sold Medicaid managed care plans to states, has been a big player in the reversal. It alone has filled more than half of all identified bare counties, part of a big bet on Obamacare.
It's a bet that has continued to pay remarkably considering how many times and how close the law has come to destruction. With repeal continuing to fade into the background, the question is whether the law—and insurance for millions of people—will exist under the malignancy that is the Trump regime.