While residents of some counties in America will have no options on health insurance exchanges, many Kentuckians are currently projected to have only one.

The Centers for Medicare & Medicaid Services (CMS) released a county-level map this week of 2018 projected health insurance exchanges participation based on the known issuer participation public announcements through June 9. The map shows that insurance options on the exchanges continue to disappear as plan options are down from last year.

In Kentucky, the majority of counties will have only one health insurance option again. The biggest change is that Humana Health Plan will no longer offer exchange plans.

Humana announced earlier this year it “cannot continue to offer this coverage for 2018.” The company cited further signs of an unbalanced risk pool. It offered exchange plans in only nine counties in Kentucky in 2017.

Despite the exit, Humana remains committed to serving its current individual medical policy members through the remainder of 2017, a spokesperson said.

Anthem Health Plans of Kentucky was the only company to offer coverage on the exchange in every county in the state for 2017. A spokesperson said the company will be filing rates and plans next week per the schedule of the Department of Insurance (DOI).

The CMC’s county-level map projects a portion of Kentucky counties will have a second option, which will be CareSource.

This year, CareSource offered plans in 61 counties, which was up from 46 in 2016.

CareSource said it is preparing to offer affordable quality coverage in 2018 in the states “where we have plans, which includes Kentucky.”

With Humana no longer offering plans on the exchange, Kentucky has lost five providers of exchange plans in past two years. Baptist Health Plan, United HealthCare, WellCare and Aetna did not offer plans in 2017 after doing so in 2016.

The CMS county-level map displays point-in-time data and is expected to fluctuate as issuers continue to make announcements on exiting or entering specific states and counties, according to a CMS release. The map currently shows a total of 47 counties across the country are projected to have no insurers, meaning that Americans in these counties could be without coverage on the exchanges for 2018.

According to the CMS map, as many as 1,200 counties — nearly 40 percent of counties nationwide — could have only one issuer in 2018. Currently, for 2018, at least 35,000 active exchange participants live in the counties projected to be without coverage and roughly 2.4 million exchange participants are projected to have one issuer, the release noted.

“This is yet another failing report card for the exchanges,” said CMS Administrator Seema Verma. “The American people have fewer insurance choices and in some counties no choice at all. CMS is working with state departments of insurance and issuers to find ways to provide relief and help restore access to healthcare plans, but our actions are by no means a long-term solution to the problems we’re seeing with the Insurance exchanges.”

Qualified Health Plan submissions for the federally-facilitated exchanges will be accepted by states and CMS through June 21.

Jonathan Greene is the editor of The Register; follow him on Twitter @jgreeneRR.

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