In Virginia, Anthem planned an exit that would have left more than 60 counties without any individual insurance options, but changed course two weeks ago after discussions with the state.
"Bare counties is a highly political issue and health plans have been concerned about the consequences of being called out publicly," said Caroline Pearson, senior vice president at healthcare consultancy Avalere Health.
Scant Competition. High Prices
The push could not preserve competition in many states. In 2018, nearly half of U.S. counties will have only one insurer offering individual plans, according to federal data. In 2017, a third of counties had only one insurer. In 2016, only 7 percent of counties had only a single choice.
But it did convince some to alter plans. Molina Healthcare said in July it would exit two states and was considering further departures.
In the end, it is remaining in seven states where it sells individual plans - include California, Florida, Michigan, New Mexico, Ohio, Texas and Washington - a spokeswoman said Tuesday.
Cigna Corp, which had planned to sell Obamacare coverage in six states for 2018, said it will make final details public after the deadline. Anthem and HealthCare Services Corp, which runs Blue Cross Blue Shield in Illinois, Texas and other states, did not comment further on their plans.
Such insurers will wade into 2018 Obamacare markets with no certainty over the program's fate. Senate Republicans on Tuesday failed again to muster enough votes to repeal and replace the 2010 Affordable Care Act, but vowed to revive the effort in the coming months after tackling tax reform.
State health commissioners allowed them to propose monthly premium increases of 20 percent, or even more, from 2017 to compensate for the uncertainty.
"We didn't really have much choice," McPeak of Tennessee said. "We were fearful that insurers, if they filed lower rates, would decide not to come into the market."