As the deadline for payers to enroll into the ACA approaches, The Hill reports that these five places will be most impacted by payers leaving the ACA.
1. Missouri
Twenty-five of the state's counties currently have no payer in their ACA marketplace. Blue Cross Blue Shield of Kansas City announced it would cease offering individual coverages in May. It's possible that the payer could return to the exchanges or another payer could enter the counties.
Final decisions aren't due until fall 2017.
2. Iowa
Medica covers most Iowa counties. The payer hasn't decided whether it'll offer policies next year. Gunderson Health Plan, which sells policies in five counties, is also undecided.
Aetna and Wellmark Blue Cross and Blue Shield both withdrew from the exchanges.
Wellmark could re-enter the exchanges if legislators alter some policies.
3. Nebraska
Medica is also the only payer offering plans in Nebraska. Aetna exited all Nebraska exchanges in May.
4. Knoxville, Tenn.
Knoxville's last payer Humana announced it would leave the exchanges in February. The state's insurance commissioner reached out to several payers to fill the void.
Blue Cross Blue Shield of Tennessee agreed but with several reservations.
The Hill predicts that payers will flee the exchanges en masse if the government doesn't fund payer subsidies.
5. Rural areas
With exchanges in several rural areas down to one offering, if payers leave there will likely be no replacement.