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The lone U.S. county still at risk of leaving shoppers with no choices next year on the federal health law's insurance marketplace has landed an insurer. Ohio-based insurer CareSource will step up to provide coverage in Paulding County, Ohio, in 2018, the company and the state Department of Insurance announced Thursday. (Smyth and Murphy, 8/24)

Although insurers could still defect in the next month, before they must sign federal contracts to sell ACA coverage for the coming year, the move by CareSource to sell marketplace health plans in Paulding County, on the western edge of Ohio, appears to end a recent scramble by officials in seven states to persuade insurance companies to participate in a total of 81 counties. Those potential bare spots emerged mainly as large, nationwide insurers have withdrawn from all or most of the ACA marketplaces they once served — a result of sicker and more expensive customers than they had expected and uncertainties bred by Republican efforts to overturn much of the 2010 health-care law. (Goldstein, 8/24)

CareSource’s chief executive, Pamela Morris, said the decision “was the right thing to do as a mission-driven company.” CareSource was able to agree to offer exchange plans in Paulding County because it has a presence in a neighboring county in the adjacent state of Indiana and thus has a network of health-care providers there. Ms. Morris said CareSource, which offers exchange plans in four states, was “fully committed” to those marketplaces, despite uncertainty about federal decisions related to the health-law marketplaces. (Wilde Mathews, 8/24)

Despite President Donald Trump's claims that Obamacare is "dead" and repeal efforts in Congress, the Ohio announcement is the latest evidence that the health care law's insurance markets are proving to be resilient. (Demko, 8/24)

Insurers such as UnitedHealth Group Inc, Aetna Inc and Humana Inc have exited most of the states where they sold Obamacare plans, leaving hundreds of U.S. counties at risk of losing access to private health coverage in 2018. ... But other insurers, like Centene Corp, have filled those gaps, expanding into new counties that had lost their coverage options. (Erman, 8/24)

The Trump administration downplayed the news, arguing that competition is lacking on the exchanges with many counties slated to have only one insurer next year. “On ObamaCare’s exchanges premiums continue to surge, insurers continue to abandon wide swaths of the country, and choices continue to vanish,” HHS spokesman Matt Lloyd said in a statement. (Hellmann, 8/24)

Even though all counties are now covered, consumers still face few or no choices in some places because of the pullbacks. About 23 percent of Obamacare customers, or 2.5 million people, live in counties where only one insurer plans to offer coverage next year, according to data compiled by Bloomberg. Another 26 percent are in counties with two options. (Tracer and Recht, 8/24)

Earlier this year, more than 40 mostly rural counties across the country faced the prospect of having no options for their exchanges. Insurers who withdrew cited steep losses and a lack of clarity over the future of President Obama’s Affordable Care Act. Many counties still have only one insurer, and premiums in many regions will increase significantly next year due to the financial pressures facing insurers. (Ross, 8/24)

"Working through this challenge has been a priority for the Department and our staff in recent weeks and I'm proud of the collaborative approach insurers have been willing to take so that we could come together and solve this problem," Jill Froment, director of the Ohio Department of Insurance, said in a statement. "There is a lot of uncertainty facing consumers when it comes to health insurance and these announcements will provide important relief." (Koff, 8/24)