WASHINGTON -- Existing health insurers have agreed with the Ohio Department of Insurance to step in and serve nearly every Ohio county that otherwise would lack even a single insurer in the Obamacare market next year.

As a result, residents in 19 of the 20 counties that could have lacked a single carrier in the Affordable Care Act insurance exchange will have at least one insurer. The Ohio Department of Insurance is working to find an insurer for the final county.

Put another way: As of today, 87 of Ohio's 88 counties will have at least one insurer in the ACA individual market next year. The fear that 20 counties would lack that option is no more.

"Knowing 20 counties might not have access to health insurance on the exchange in 2018, our team went to work with the companies to find a way through the challenge, and together we have identified a solution," Ohio Department of Insurance Director Jillian Froment said in a statement.

"Ohio has long had a strong insurance system and once again our insurers stepped up at an important time for thousands of Ohioans, taking unprecedented action to provide access to health insurance for Ohioans who otherwise were without options."

The prospect that 20 counties would lack a single carrier followed announcements that Anthem Blue Cross Blue Shield of Ohio, covering the entire state, and Premier Health Plan, a smaller insurer based in Dayton, decided to exit the ACA market in 2018. The insurers cited uncertainty in the market, including an ongoing question of whether the federal government will provide payments it was supposed to under the ACA.

That uncertainty continues, and President Donald Trump could make a decision on it this week. He has threatened in the past to stop the payments, as a 2016 court ruling could allow, if Congress did not repeal and replace Obamacare. Senate Republicans last week failed in their latest attempt to do so.

But meanwhile, the Ohio Department of Insurance worked with other carriers to eliminate what could have been a problem in a number of rural counties where Anthem or Premier was exiting.

This means only Paulding County, in western Ohio, will lack an ACA carrier. State officials say they hope to remedy that problem, too.

Helping solve the problem in the 19 other counties are Medical Mutual of Ohio, Buckeye Health Plan, CareSource, Molina Health Care and Paramount Health Care. The breakdown by county:

Buckeye Health Plan: Harrison, Logan, and Van Wert.

CareSource: Guernsey, Jackson, Lawrence, Morgan, Muskingum, Noble, Perry, and Vinton.

Medical Mutual of Ohio: Crawford, Knox, Hocking, and Hancock.

Molina Health Care of Ohio: Coshocton, Hancock, and Holmes. Since both Medical Mutual and Molina are adding Hancock County, the county will go from the prospect of lacking a single ACA insurer to having two.

Paramount Health Care: Williams and Wyandot.

Insurers are still finalizing their filings, including the plans they will offer and the premiums. Based on comments from the insurers, it appears that the carriers have reached agreements with local doctors and other providers, although those details are not yet public. Premiums are not yet public either but could be soon.

"We're fortunate to be able to play a part in the solution, but it shouldn't be overlooked that the willingness of local providers to come to the table is what allowed us to get to this point," Steffany Larkins, executive vice president at Medical Mutual, said in a statement.

Bruce Hill, CEO of Buckeye Health Plan, noted that the addition of three of the counties for his company was only part of its expansion to new counties. Buckeye's "Ambetter" coverage will grow from nine to 27 Ohio counties in 2018.

"Working in partnership with the state to include three of the bare counties helps ensure that Ohio residents will continue to have access to high-quality, comprehensive health care," he said.

Pamela Morris, CareSource president and CEO, said her company's decision to add eight counties is consistent with the company's ongoing commitment to the marketplace.

"As a result of our 28-year history of serving uninsured populations, we see firsthand the value affordable health care coverage offers to families in Ohio," Morris said.