The Ohio Department of Insurance announced Thursday that CareSource will sell Affordable Care Act (ACA) plans in Paulding County, officially marking the end of the health law’s empty counties problem. Every person looking to buy coverage on the ACA marketplace in Ohio and nationwide will have at least one health insurance option.

The Kaiser Family Foundation (KFF) has been tracking the state of counties that were at risk of having no insurer in 2018 at some point since February 2017. On Thursday afternoon, the map — once riddled with orange dots, to indicate no insurer participants — is now gray:

Credit: Kaiser Family Foundation

The current health law survived its latest immediate threat of bare counties, but with little assistance from the federal government. Bare counties have been largely filled due to tough negotiating between the state officials and insurance companies. Two companies, CareSource and Centene, covered 55 of the 82 counties that were once at risk of having no ACA coverage, according to KFF’s Cynthia Cox.

House Speaker Paul Ryan (R-WI) said Monday evening that “dozens of counties” across the country had no insurer on the marketplace. The remarks were false. At the time of his comments, only Paulding County, Ohio was without an insurer. The bare county problem has been a talking point among Republicans who say the health law is imploding. Obamacare is not imploding. There are valid concerns and criticisms; namely, the limited insurers participation.


The ACA is also being undermined by the federal government. The president refuses to commit to subsidy payments to insurance companies and federal agencies have not been communicative about open enrollment strategy and marketing. The Trump administration has also been using Obamacare funds for a PR campaign against the health care law.