december talking about bipartisan to stabilize the health insurance market for 2018. let's start there. what's your sense of the condition of those markets right now? >> i think there's a lot of consensus what is needed to shore up or strengthen the affordable care act marketplaces. going into 2017, there was a lot of evidence, financial and otherwise insurance companies were starting to find their footing after a few rocky years. the policy uncertainty coming out of washington, debate over whether they will repeal the aca or not repeal the aca, whether there will be an individual mandate, that penalty for not having insurance, all of that uncertainty is causing insurance companies to be very nervous about their long term participation. so i think going forward, the condition of the markets is that we don't know, because there's still some key decisions that need to come out of washington to give insurers that confidence they need to stay in the market. >> joseph, i want to get your thoughts on the conditions of the markets. first, that announcement, that sabrina mentioned, what is the white house considering right now? they have some decisions to make about money being put into the system. >> the biggest decision whether they commit to making moll payments to insurance companies to compensate them for what are called -- i lost -- >> cost sharing. >> cost sharing reductions which basically means instead of paying a $6,000 deductible if you're low enough income, your deductible might be much lower, might be $500, $1,000. that's big money. that's $7 billion over a year. this is something that really matters. but it's also a matter of great debate because congress never appropriated the money. and there's a real argument now within the administration, republicans argued for basically four or five years that that money shouldn't be spent. now they're in charge and now they're faced with do they spend it or not. >> phone numbers on the bottom of our screen for guests, republicans, democrats and independents. we have a separate line here, we want to point out -- actually, let me start over because we have two lines i think we're doing through this segment. if you're insured through the aca, called 202-748-8,000. all others call 202-748-8001. >> 202-748, 8000 through the aca. that second one is for all others. we'll get to your calls in just a few minutes for our guests. wanted to use some cms projections to paint a picture what's happening with those exchanges. they wrote in july 40 counties are projected to have no insurers next year. 1,332, over 40% of counties nationwide could have only one issuers and at least 28,000 are currently enrolled for health coverage in those counties to have no coverage. more on the state of the country out there. >> sure. those numbers are a little bit out of date. just yesterday there was an announcement in ohio most of the counties, all but one county will be covered next year. it's a lot fewer counties than what the trump administration projected about a month ago. that said, i think as joe pointed out, the issue of subsidies to reimburse for low cost sharing plans, that's a really critical decision. we could either see a lot more counties without a participating carrier if they learn they're not going to be paid back for those expenses or we could see every county covered if they get some certainty about that. that's a decision everyone is on the edge of their seat for. >> joe. >> so one of the reasons why we have this good news from ohio is that in fact states are not helpless in this regard. states can make changes within current law without any changes from congress to shall we say encourage and possibly coerce insurers to stay in some of these counties. in particular, one of the best techniques is to combine rating areas, basically within a state, you may have a city, you may have a suburb, a rural area. oftentimes each of those areas are different locations as far as what the premiums are going to be and whether an insurer has to be there. a state can say we will combine the suburbs with a rural area. that broadens the so-called risk pool and brings in more people. that gives a shot at least at a market that an insurer could potentially see as a long run possibility. >> before we go to calls, let's hear from chuck schumer on the floor yesterday talking about the president and what he sees as the president's threats to cut these cost sharing payments. here's a look. >> now, mr. president the american people are looking to congress to turn the page on healthcare and start with bipartisan improvements on our healthcare system. stabilizing the individual market is the first thing we should all focus on. the repeated attempts to repeal and replace the healthcare law as well as the administration's threat to stop making the cost sharing payments that help keep premiums down and keep markets stable has injected massive uncertainty into the system. insurers hate nothing more than uncertainty. it drives them to jack up the costs of premiums and pull out of markets. >> let's hear from our guests beginning with joe antos. >> there's some irony, it's true insurers don't like uncertainty, some irony, insurance is supposed to take care of risks, related to uncertainty. it's a little late. it's really great to hear that senators want to hold hearings in september. but this is a problem that could have been resolved the beginning of the year. since insurers have to make up their minds finally one way or the other by sometime near the end of september, it really doesn't give them much of a chance to react to good news or bad news. what's their fix? increase premiums. that doesn't necessarily mean they will drop out of the market. it will mean taxpayers will pay a lot more money for the same thing. >> sabrina corlette. >> i agree with joe. i believe insurers will respond to this with premium increases. if you get a subsidy through the affordable marketplace because you're based on your income, you should be insulated to some degree because your subsidy will rise to compensate for that. if you're not subsidized, you will bear the full brunt of that price hike and it could be steep in a number of places. >> let's go to calls for our two guests. we just had the two lines here. if you're insured through the aca call 202-748-8000. and the others, 80001. george, you have insurance through the aca, correct? >> caller: that's correct. >> go ahead, sir. >> caller: one thing i wanted to point out, as far as the insurance is concerned, we really never had a big problem until the -- these trade deals came out and took all these people out of the system, when these companies folded up here in the united states and sought work -- i mean, sought to get their business done some place else. the other thing is that it's quite obviously that our congress and senators are supporting the insurance companies versus supporting the american people. it's time to go to a medicare -- stop paying these insurance companies all this money, stop -- and go to a -- i mean, go to a system where we can pay directly to medicare system, take that money you were just talking about, paying these insurance companies and putting it in a medicare for all. that's do the right thing for americans here and there's all these countries that have medicare for all for their company -- i mean for their countries and their citizens and they pay half the costs of what we pay here in the united states. let's stop all this wrangling and bull crapping and let's do the right things for americans. stop giving the insurance companies the money, put it in a fund to provide for coverage for everybody in the united states. let's do the right thing. that's all i've got to say. >> thanks for calling. let's start with sabrina corlette. >> sure. there are a number of countries in europe and canada and elsewhere that have largely government run healthcare systems. i think they have pros and cons. i think the medicare for all idea is one that certainly has been put forward in congress before. has never, at least to date, has not garnered much political support from either party, frankly. that, i think that dynamic could change a little bit if you really see these individual markets collapsing. and insurers pulling out. you could see a pendulum shift in the political calculus, where more and more democrats could start to call for a single payer system. with any healthcare system the devil is very much in the details. while certainly a single payer system could simplify things and insure healthcare is a basic right for all americans, there could be issues in terms of provider participation and making sure people have access to care. services that could be more limited. there are pos and cons with every approach and winners and losers. to date today the medicare for all concept has not had a lot of political support. >> single payer going down late in the senate last week. you want to add? >> a good reason why it's not getting much support, senior citizens tend to be the most active voters in the country. as president trump and virtually every other president who has ever held the office has said, we will protect the medicare program. partly because it's a relatively sound program and partly because of politics. we're talking about people who have a lot of sway at the polls. george also makes another good point, really at the heart of the matter. you have to start from where you are. where we used to be was a dominant employer-sponsored covered system. whether you can blame it on trade deals or changes in technology, changes in the way the economy operates, whatever the reason is, it is true lower income people used to have good jobs, may not have those jobs, may not be able to get coverage through their employers. that is, i think, the major source of not only the angst over health insurance but all of the country. >> to jim in fairfield, connecticut, has insurance through the aca. good morning. >> caller: good morning. >> i want to see if you can first explain to us your first experience so far with the aca, what it's been like for you? >> caller: extremely positive. the connecticut exchange is well run, well managed with limited choice but good choice. there are two insurance companies in the aca in connecticut, anthem and connecticut-care. connecticut-care bullied it would drop out of the system but they changed their mind for some reason and two providers in connecticut. i receive my coverage through anthem blue cross, a bronze plan and i pay my premiums but i receive subsidies. where there's only one provider or no provider, the state regulator in those states should demand if they do not provide coverage in certain counties they should be kicked out of the state and not provide coverage to anyone in the state. if that becomes the case, the citizens of those areas should receive a government-sponsored program. the other thing is that the sub -- the individual mandate needs to be enforced in order for this good law to take effect. right now, there isn't any strict enforcement. the penalty needs to be a lot stiffer than $100 on your tax return. it should be something that becomes a penalty for not getting insurance. the young people and the healthy people need to be encouraged and almost bullied into getting insurance for themselves because if only the older the sick, this is just stating the fact, if only the old and sick are in the pools, the rates will go up and insurance companies will demand more money for providing coverage. >> thanks for calling. let's's hear from our guests. we begin with a map. >> go ahead. >> well, good morning. thanks very much for being here today. we're here today because we believe in an america