News that insurance companies are getting out of ObamaCare exchanges may leave consumers with little to choose from.

Aetna says that it’s getting out of all but four ObamaCare exchanges for 2017. As outlined by USA Today, Aetna is ending its ObamaCare plans in 11 states: Arizona, Florida, Georgia, Illinois, Kentucky, Missouri, North Carolina, Ohio, Pennsylvania, South Carolina and Texas. Aetna’s ObamaCare members in Delaware, Iowa, Nebraska and Virginia will be unaffected.

Earlier this year, UnitedHealth announced it would be pulling out of almost all of the exchanges.

This means that participants in affected states will be forced to sign up for other ObamaCare plans, although consumers may want to shop around because of expected premium increases for many plans.

Paul Howard of the Manhattan Institute says Aetna’s announcement may not leave consumers with much to choose from.

Howard

“It’s all going to be state- and county-specific, but we’re going to have an increased number of counties, probably hundreds of counties, that are only going to have a single insurer offered,” says Howard.

The Wall Street Journal reports that Aetna’s move puts at least one county, Pinal County in Arizona, at risk of having no insurers that offer plans. Howard expects regulators will do their best to try to help those people. Either way, he says that’s “not great for competition in terms of holding costs down and ensuring that consumers have better, more affordable options available to them.”

Speaking of better, more affordable options, Howard expects a lot of people to once again sit out of the exchanges in 2017.

“Until the offerings get more affordable and more attractive to younger, healthier, more affluent patients – who you have to get in the market to stabilize it – they’re going to continue to sit it out,” he predicts.

Howard considers that to be a political time bomb for the Obama administration, which people are not focusing on enough. “The plans just aren’t things that people want to buy with their own money,” he says.

Something is amiss

Ed Haislmaier, senior research fellow in health policy studies for The Heritage Foundation, says Aetna’s announcement was particularly important because among the larger insurers, that provider has been the most disciplined and cautious in its approach to the Obamacare exchanges.

Haislmaier

“They were willing to be on more exchanges than anybody else, but they insisted on charging premiums they felt were enough to cover their costs – [and] they still lost money,” he notes. “So when an insurer that’s being thorough and cautious pulls out, that tells you something’s really amiss.”

Meanwhile, which company will now have the biggest presence on the exchanges?

“With United and Aetna pulling back, and even Humana, the largest presence will almost certainly be Anthem – and that’s because Anthem is really a collection of 14 Blue Cross plans, almost all of which are statewide Blue Cross,” Haislmaier explains.

“For example, Anthem is the Blue Cross in Georgia, [and] it’s the Blue Cross plan in almost all of Missouri, except for the area around Kansas City. So Anthem will almost certainly be the largest footprint.”