At the heart of Barack Obama’s vision for US healthcare reform were online marketplaces in which Americans would buy low-cost health coverage from thriving insurers. In Pinal County, Arizona, a semi-rural district outside Phoenix, it has not gone according to plan.
After three big insurers including Aetna said they would abandon so-called Obamacare exchanges next year, Pinal County faces the prospect of becoming the first place where not a single company wants to sell insurance on its exchange.
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Jackie Shore, a nurse who helps people navigate the system, says she is already receiving calls from worried patients in the county, home to 400,000 people. “They’re in bad shape financially as it is and now they might have even more limited options,” she says. “It’s really going to become a crisis.”
Pinal County is an extreme case, but it reflects deep-seated problems dogging Mr Obama’s reforms, known as the Affordable Care Act. They are threatening to undo a signature achievement of his presidency as the clock ticks down on his final five months.
America’s Health Insurance Plans, a trade group for the many unhappy US insurers, complains that the marketplaces are “unstable”.
