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A Project of The Annenberg Public Policy Center

Trump’s Tennessee Tale

In making his case to replace the Affordable Care Act, President Donald Trump falsely claimed that in Tennessee “half of the state has no insurance company” on the ACA marketplace. In fact, all eight of the state’s rating areas have at least one carrier and three of them have two carriers.

Trump met at the White House with a group of House members on March 17 to discuss the American Health Care Act. With the House members seated with him in the Oval Office, Trump discussed his recent visit to Tennessee and the state of its health care system.

Trump, March 17: I was in Tennessee — I was just telling the folks — and half of the state has no insurance company and the other half is gonna lose the insurance company. The people don’t know what to do. It’s a disaster. Obamacare is dead.

Tennessee divides the state into eight rating areas. Three of the eight — the East, Greater Nashville and Greater Memphis areas — have two carriers selling health insurance on the federal marketplace set up by the Affordable Care Act, according to the state’s 2017 rating area plans and rates. The other five rating areas have only one carrier.

It is important that at least one company is selling insurance on the marketplace in each rating area, because the federal government provides tax credits and subsidies to help pay for insurance only for those who purchase plans on the exchanges set up by the Affordable Care Act.

Insurance carriers in the ACA marketplace offer multiple plans — such as bronze, silver and gold — which offer different levels of coverage at different prices. And a company may offer more than one of each level. For example, Cigna sells three bronze plans, four silver plans and one gold plan in Greater Nashville, according to the state’s rating plan.

We confirmed with the state Department of Commerce and Insurance that no rating area in the state is without at least one health insurance company on the ACA marketplace. “The rating areas brochure is still correct,” Kevin Walters, a department spokesman, told us in an email.

Walters did say, however, that it is possible that some parts of the state will be without marketplace coverage next year.

Humana announced last month that it will no longer sell insurance on the ACA marketplace. “Humana is currently the only insurer on the exchange in the greater Knoxville area — meaning if another insurance company does not enter the market, there will be no Obamacare exchange in that area,” the Tennessean wrote.

“We are hopeful that a carrier will offer coverage for that area in 2018, but so far there has been no replacement,” Walters said, adding that without a replacement there would be 79,000 residents in the state without access to a marketplace insurance plan. There were more than 234,000 ACA plans selected in Tennessee during enrollment period that ended Jan. 31, according to the U.S. Department of Health and Human Services.

It may be that some in Tennessee will be without a marketplace insurance plan next year, but Trump is wrong to say that “half of the state has no insurance company and the other half is gonna lose the insurance company.”

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Under Obamacare in Tennessee, “half of the state has no insurance company and the other half is gonna lose the insurance company.”
Donald Trump
President of the United States

Oval Office
Friday, March 17, 2017