15 out of 64 Colorado counties now only have one Obamacare insurer in their health insurance marketplaces.

This week, Congressional Republicans revealed legislation they are calling the American Health Care Act. This legislation would repeal and replace the Affordable Care Act, also known as Obamacare. Once the amendment process is complete, the final bill will likely look nothing like what Congress started out with. One aspect of the initial bill that should interest many Coloradans is the option for Americans to buy health insurance across state and county lines. Under the Affordable Care Act, Americans are required to purchase insurance through their State and county-level exchanges. Because health insurance providers have started pulling out from many rural county-level exchanges, millions of Americans are now left with just one health insurance company to choose from. The US Department of Health and Human Services recently released data showing that more than 1,000 counties in the United States (roughly 1/3 of all counties) were down to just one Obamacare insurer in the marketplace.

In Colorado, 15 counties only have one health insurance option in the marketplace. Coloradans living in Archuleta, Delta, Dolores, Gunnison, Hinsdale, Jackson, Lake, Mesa, Moffat, Montrose, Ouray, Pitkin, Rio Blanco, San Juan, and San Miguel Counties. These counties can currently only buy health insurance from one company; Anthem Insurance. Gradually, health insurance providers have announced their withdrawals from state and federal health insurance exchanges. The result is that now roughly 308,000 Coloradans can only purchase health insurance from one Obamacare insurer. This creates a health insurance monopoly in these counties. Instead of having multiple companies competing with one another for insurance buyers, Anthem is able to charge residents in these counties any price without fear of another provider undercutting their offerings. Because the Affordable Care Act requires all Americans to purchase health insurance, these Coloradans find themselves in a difficult spot. They can’t afford to opt-out of the exchanges but because of a complete lack of competition in the marketplace, they also can’t afford to opt-in either. All of these counties are located in Colorado’s Third Congressional District. Congressman Scott Tipton (R-CD3) is one of Colorado’s leading advocates behind repealing and replacing the Affordable Care Act. Rep. Tipton recently penned a column that details the issues surrounding health insurance marketplace monopolies in his district;

“We can’t say health care is affordable and accessible when for many families, there is only one insurer to choose from and their premium is more than their mortgage payment each month.”

Health insurance providers continue to withdraw from state and county-level insurance marketplaces. Humana was the most recent company to announce it will be pulling out of the Obamacare exchanges starting in 2018. With the way the law is structured, it simply isn’t economically viable to have multiple insurance companies competing for the 685 people living in San Juan County or the 809 residents of Hinsdale County. This is especially true when you consider that many of these residents aren’t shopping on the private exchange because they receive insurance through their employers. They are seen as statistically insignificant.

Until the law is changed to make it easier for providers to compete in these rural counties, or to allow Americans to buy health insurance across state and county lines, the number of Colorado counties with one ACA insurer will continue to grow.