Sign up for our daily briefing

Make your busy days simpler with Axios AM/PM. Catch up on what's new and why it matters in just 5 minutes.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Catch up on the day's biggest business stories

Subscribe to Axios Closer for insights into the day’s business news and trends and why they matter

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Stay on top of the latest market trends

Subscribe to Axios Markets for the latest market trends and economic insights. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Sports news worthy of your time

Binge on the stats and stories that drive the sports world with Axios Sports. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Tech news worthy of your time

Get our smart take on technology from the Valley and D.C. with Axios Login. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Get the inside stories

Get an insider's guide to the new White House with Axios Sneak Peek. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Denver news?

Get a daily digest of the most important stories affecting your hometown with Axios Denver

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Des Moines news?

Get a daily digest of the most important stories affecting your hometown with Axios Des Moines

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Twin Cities news?

Get a daily digest of the most important stories affecting your hometown with Axios Twin Cities

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Tampa Bay news?

Get a daily digest of the most important stories affecting your hometown with Axios Tampa Bay

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Charlotte news?

Get a daily digest of the most important stories affecting your hometown with Axios Charlotte

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

The nightmare scenario for Obamacare is a meltdown of the individual health insurance market. If health insurers lose confidence as Republicans struggle with their repeal efforts — or because of the turmoil and price hikes that have already been underway — even more could withdraw, leaving Obamacare customers with nowhere to turn to keep their coverage.

Humana has already done this, raising fears that the meltdown could actually happen. But it's always a vague threat, with no real specifics. Katherine Hempstead and her research team at the Robert Wood Johnson Foundation helped Axios map out the likely impact if other insurers that have been on the fence decide to pull out.

Here's what it would look like: If insurers like Anthem decide to exit the exchanges for 2018, hundreds of thousands of people would be stranded without any available insurers. Some state marketplaces would almost certainly fall apart.

Expand chart
Data: Centers for Medicare and Medicaid Services and Robert Wood Johnson Foundation; Chart: Andrew Witherspoon / Axios

Humana is the source of the latest fears. The insurer said it was completely exiting the Obamacare marketplaces for 2018. That meant the coverage for more than 40,000 Humana members in Tennessee's individual market was thrown into disarray. Humana was the only option for them, and now it's unclear what will happen to those members for next year.

That's a sizable number of people, but Humana isn't a major Obamacare player. It will get even dicier if companies with larger memberships decide to bail.

"A lot of these big carriers have a big impact in their market," Hempstead said. "There's not a lot of room to play with if there are exits."

Here's what would unfold if each of these individual companies quit Obamacare, based on Hempstead's analysis for Axios. (Note: This only includes plans sold on the exchanges.)

  • Anthem: An Anthem exit would cause arguably the most disruption nationwide. Roughly 255,000 people across Colorado, Kentucky, Missouri and Ohio would have no Obamacare insurers for 2018, and 560,000 people in eight states would have just one insurer. CEO Joseph Swedish, who has demanded specific changes, recently supported many parts of the Republican repeal bill.
  • Centene: The marketplace in Mississippi would implode. If Centene left, 90,000 Mississippi residents would have zero insurers. (Humana is already leaving, and the state Blue Cross Blue Shield plan isn't participating.) Another 180,000 people across Georgia, Texas and Washington would have only one option.
  • Cigna: Tennessee would be hit even harder with a Cigna departure, as 105,000 people in 14 counties would have no Obamacare options. More than 275,000 people in six states would have one remaining insurer if Cigna bolted.
  • Highmark: Roughly 10,000 people in the Trump stronghold of West Virginia would have no insurers. States that are dominated by other major not-for-profit Blue Cross Blue Shield companies, such as Health Care Service Corp. and the Alabama Blues, also would see their exchanges crumble quickly if they left.
  • Molina Healthcare: Not a big impact here. One county in Wisconsin would be left with no Obamacare plans. Molina is still a big Obamacare carrier, but it operates in a lot of competitive areas that have other options.
  • Aetna and UnitedHealth Group: These two companies have already withdrawn from most of their Obamacare markets.

The bottom line: Health insurers need certainty very soon about what the individual markets will look like. The market stabilization rule has assuaged some industry concerns, but the Republican replacement plan has not. Molina's CEO told Axios the GOP plan "doesn't reassure me that the marketplace is going to be more stable in the future." And for every insurer that leaves, "it raises the stakes for the next carrier to leave," Hempstead said.

Go deeper

Delivery industry sees biggest monthly job losses in more than 20 years

Data: U.S. Bureau of Labor Statistics; Chart: Axios Visuals

The pandemic's biggest job winner is losing steam.

Driving the news: People who deliver packages to businesses and homes — classified as "couriers and messengers" by the Labor Department — saw the industry's biggest monthly job losses in more than 20 years in April.

FDA authorizes Pfizer COVID vaccine for 12- to 15-year-olds

Photo: Gabby Jones/Bloomberg via Getty Images

The Food and Drug Administration authorized the emergency use of the Pfizer-BioNTech coronavirus vaccine for 12- to 15-year-old adolescents, the agency announced on Monday.

Why it matters: The emergency authorization marks a critical milestone in the push to get more Americans vaccinated and fully reopen schools for in-person learning this fall.

GOP to vote on ousting Liz Cheney this Wednesday

Photo: Tom Williams/Pool via Getty Images

House Republicans will vote on recalling Rep. Liz Cheney (R-Wyo.) as conference chair this Wednesday, House Minority Leader Kevin McCarthy announced in a letter Monday, Punchbowl News reported.

Why it matters: Cheney, the No. 3 House Republican, has faced increasing backlash from McCarthy and her Republican colleagues as she continues to criticize former President Trump and his baseless claims of election fraud.