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In 2017 about 41 percent of rural counties had only one Obamacare health insurer, Roubein notes. There is fear that "without certainty, insurers could exit marketplaces, leaving rural areas without any carriers," she writes. "Rural hospitals could then be tasked with providing care to a population that could be increasingly uninsured." Cynthia Cox, associate director of Kaiser Family Foundation’s Program for the Study of Health Reform and Private Insurance, told Roubein, "It really does all come down to that one company's decision about whether to stay or go."
House Republicans are trying to revive their bill to repeal and replace Obamacare, which fell apart last month. "Meanwhile, insurers are readying their rates for plan year 2018 and want to know that they’ll continue to receive payments for providing their consumers with cost-sharing reduction subsidies," Roubein reports. "The White House hasn’t been particularly clear on what it will do, as Trump floated the possibility of ending the payments to force Democrats to the healthcare negotiating table. Health executives met a top Trump health official on Tuesday but came out with no assurances."