This post was originally published on Aug. 23, 2017. Since then, an insurance company has come forward to provide Obamacare coverage for Paulding County, Ohio.


After the doomed attempt on Capitol Hill to repeal and replace Obamacare, key Republicans continue to falsely claim that the system is on the verge of collapse.

Instead, what has happened in recent months is that the private insurance market has stepped up to fill many of the gaps created when major insurers dropped out. To be sure, the Obamacare program certainly isn’t working as hoped, but it still maintains resilience thanks to market forces. After all, this was a concept borne in conservative circles based on tax credits for the uninsured, coupled with an individual mandate that could be labeled the “freeloaders tax.”

The nonprofit Kaiser Family Foundation now confirms that 3,006 of the 3,007 counties in the United States have Affordable Care Act (ACA) marketplace plans in place for next year. The one county that doesn’t, Ohio’s Paulding County, has previously served 334 people – or, about .0001 percent of the U.S. population.

According to, Republicans futilely claim that many people will not have access to ACA health care plans in the future as they make discredited claims about a non-existent “death spiral.” Those assertions have been debunked by the nonpartisan Congressional Budget Office and now by the facts in the 2018 coverage map from Kaiser.

In Michigan, most counties still offer four or more participating insurance companies (and the various plans they sell) on the Obamacare exchange. In the upcoming 2018 enrollment period, counties throughout western Michigan will offer greater – not less –ACA coverage, with three or four companies each participating. In southeast Michigan, options will decrease but counties will still offer eight competing insurers each.

In other words, those on Obamacare in Michigan will enjoy far more health care choices than the vast majority of workers who rely on employer-provided health insurance. Even unionized companies cannot offer their workforce the insurance industry competition that the ACA provides.

Vox reported back in June that dire predictions for Obamacare were based on hyperbole. For example: “Honestly, the marketplaces are in OK shape,” said David Anderson, a research associate at Duke University who studies the individual market. “The amount of competition isn’t where some people would like it to be, but this isn’t collapse.”

Here’s more:

So far, we’ve seen some health insurance companies exiting the Affordable Care Act marketplaces — but we’ve also seen some health plans expanding their footprint. There are a handful of trouble spots where no health plans want to sell coverage, but we also have a number of instances this year where insurers have identified those gaps and decided to fill them in.

The Affordable Care Act marketplaces have struggled since their launch to attract the robust competition the law’s architects desired. Where the drafters envisioned vibrant insurance markets, we’ve instead seen many monopolies and duopolies.

The marketplaces aren’t what the ACA’s boosters hoped for, but they’re mostly functioning. The health law’s subsidies coupled with the mandate to purchase insurance have meant that the marketplaces did expand coverage to about 10 million individuals. The subsidies in particular have held down the prices that marketplace enrollees pay out of pocket, meaning that this group is largely insulated from significant rate hikes.

Nonetheless, disturbingly high premiums and ridiculously high deductibles impacting some plans across the nation serve as a blackmark on the promise of Obamacare.

But the idea that the insurance industry has abandoned the ACA has become nothing more than a partisan talking point in Washington. In his televised town hall earlier this week, House Speaker Paul Ryan falsely asserted that dozens or hundreds of counties across the nation are left with no coverage.

What’s curious about all this is that the GOP continues to spout debunked claims as it portends taking another crack at wiping out Obamacare, as President Trump wishes.

The House and Senate Republican repeal-and-replace bills of the past few months were highly unpopular with the public and drew repudiation from numerous health care organizations, as well as advocacy groups such as the AARP.

Obamacare is clearly not working as hoped – mostly due to its failure to produce a pool of customers that generates profits for insurance companies – but claims that the ACA is on its death bed consist of political malpractice – or manipulation.

Overall, most of the 12 million people who landed health insurance through Obamacare’s competitive marketplaces – the exchanges — will have the same number of companies to choose among next year as they did in 2017.

Despite the drumbeat of headlines about fleeing insurers, only about 25,000 Obamacare customers were ever in danger of losing coverage.

The moves by the Trump administration to hold back on ACA payments known as cost-saving reductions (CSR) – a key component of the Obamacare system — has thrown the marketplaces into a chaotic state of uncertainty. Critics say it is no less than an attempt by the president to sabotage the entire process of providing affordable health care coverage to the uninsured.

As for the politics of all this, a new Public Policy Polling (PPP) survey released today shows that only 25% of voters support the health care bill that was considered by Congress last month while 57% disapproved of it. Even among GOP voters there’s less than majority support, with 48% in favor of it to 34% who are opposed.

At this point only 33% of voters think the best path forward on health care is repealing Obamacare, compared to 57% who think it’s keeping the current law and making fixes to it as necessary.

What’s more, voters in the PPP poll say by a 21-point margin that they’re less likely to re-elect a GOP member of Congress who supported the repeal bill — 46% are less likely to vote for a pro-repeal lawmaker as opposed to 25% who are more likely to do so.

Meanwhile, the Republican-controlled Congress overall is tied down by an astounding approval rating of just 9%. Seventy-three percent of voters disapprove of Congress, with the numbers at just 12/77 with Trump voters and 8/73 with Clinton voters.