The head of the Centers for Medicare and Medicaid Services said Thursday that she would work with states that have counties where no insurer will sell Obamacare coverage.
“We kind of have a motto at CMS: putting people first, putting patients first,” CMS Administrator Seema Verma said in an interview with reporters at the Department of Health and Human Services.
The Trump administration’s position is that Obamacare is a failed law and it has supported its repeal. But the law remains on the books so the administration is obligated to carry out the law’s provisions, which include running the open enrollment period through the healthcare.gov website where people can buy coverage.
Through Obamacare, people who do not receive medical insurance through a job or government program such as Medicaid can receive coverage, much of which the government subsidizes.
Using the website, people may have few options for plans if health insurers choose not to participate. Last year, 45 counties faced the prospect of having no insurer sell plans, but by the time open enrollment began all counties were covered. Without an insurer to sell plans, those residents can be left uninsured.
Verma said she called counties last year to see how she could help.
“This happened last year, and there was a lot of scrambling for insurance commissioners,” she said. “I made a lot of calls to insurance commissioners and said, ‘Let me know what I can do to help.'”
“We went through some ideas with them,” she continued. “We kind of understood what other states were doing to try to attract insurers and share best practices with them informally and make ourselves available to make sure that people have access to coverage.”
It isn’t clear yet if any counties will be without insurers next year. In the tax law Republicans repealed a fine in Obamacare that required people to have health insurance or pay a penalty. A deal in Congress to fund Obamacare has languished.
Insurers have warned that, as a result of these actions, more companies will seek to leave the exchanges or raise the price of premiums.
Roughly half of U.S. counties have one insurer offering Obamacare coverage. When fewer options are available the costs of premiums tend to increase and customers face the prospect of being able to only buy coverage that may not include the doctors and hospitals they prefer.
