Insurers say weakening the ACA mandate to help consumers cope with mostly bare ACA exchange shelves could drive up premiums for people who still have coverage. (Photo: iStock)

(Bloomberg) — U.S. Republican lawmakers are calling for an exemption to the Affordable Care Act’s penalties for people who don’t have health coverage if they live in places where insurers offer only one, or no, plans.

Six Republican senators introduced a bill called the “Protection from Obamacare Monopolies Act” that would exempt individuals who lack choices from the ACA’s insurance coverage shared responsibility mandate next year. About 19 percent of individuals buying health plans on the ACA’s exchanges may have only one insurer option for next, according to the Kaiser Family Foundation, up from 2 percent this year.

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While the bill probably won’t pass this year, the issue of limited Obamacare competition is gaining attention as big for-profit insurers like UnitedHealth Group and Aetna sharply limit sales of ACA plans and pull out of some states. Those exits have left one county in Arizona with no health plan offering on the exchange.

“This legislation would ensure that Arizonans are not forced to pay a penalty due to the failure of a health care system that was fatally flawed from conception,” said Sen. John McCain of Arizona, the lead sponsor of the bill. He was joined by senators Jeff Flake, also of Arizona, and Ben Sasse, Ron Johnson, Tom Cotton and John Barrasso.

Benjamin Wakana, a U.S. Department of Health & Human Services spokesman, declined to provide a comment on the legislation.

Pinal County

So far, only Arizona’s Pinal County has been left without any insurer, though state and federal officials have said they’re working to bring an insurer to the ACA exchange there. The law contains a fine for each adult in a household who doesn’t have coverage, based partly on income. HHS has previously said that the government is working to bring an insurer to the county.

Barrasso represents Wyoming, where only one insurers will offer Obamacare plans in 2017. In much of Cotton’s Arkansas and Johnson’s Wisconsin, individuals will have several insurers to pick from.

Many insurers argue that weakening the individual mandate will backfire, by encouraging healthier people to go without insurance, hurting the quality of the insured risk pool, and driving up premiums for the people who still pay for coverage.

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