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Some of the Affordable Care Acts rural insurance marketplaces, such as Pinal County, are in turmoil as the fourth open enrollment season approaches this fall. But some health care advocates feel the gap in coverage will close with time. There are some headwinds, but its not a question of whether the market will stabilize, but how quickly and how well, said Katherine Hempstead, a senior adviser at the nonpartisan Robert Wood Johnson Foundation. Strong winds are blowing with hurricane force toward Pinal County, health care advocates say. Nearly 10,000 people in the county enrolled in Obamacare marketplace policies this year and about 85 percent received a federal subsidy. In 2017, Pinal stands to lose its only two insurers – UnitedHealthcare and Blue Cross and Blue Shield of Arizona. Clearly this is a big concern for consumers, said Allen Gjersvig, director of navigator and enrollment services for the Arizona Alliance for Community Health Centers. He said he is hopeful another insurer will step in, Competition on exchanges will be diminished next year when three of the nations largest health insurers – Aetna, UnitedHealthcare and Humana – will sell individual plans in many fewer markets. So too will several Blue Cross and Blue Shield plans in various states. Thats on top of the 16 nonprofit co-ops that have closed since January 2015. The announcements, however, apply generally only to the individual market.

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