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The number of uninsured in 2018 is most likely larger than this number, but, as of the publication date, there is no reliable data available for dates beyond 2016. For 2016 data, see KFF Health Insurance Coverage of the Total Population, available at <https://www.kff.org/other/state-indicator/total-population/?dataView=1&currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D> (last visited October 24, 2018).+(last+visited+October+24,+2018).>Google Scholar

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Aetna Insurance, for example, has a multi-year reinsurance contract with Vitality ReIX to provide coverage for its large group coverage if losses exceed what it expects. See Aetna, Press Release, Aetna Announces Transaction with Vitality Re IX (January 29, 2018), available at <https://news.aetna.com/news-releases/aetna-announces-transaction-with-vitality-re-ix/> (last visited October 26, 2018). Excess Medical Reinsurance, also purchased by health insurers, functions more like stop loss insurance, providing coverage for catastrophic claims, typically those that exceed $1 million. For a more detailed discussion of these products, see D. Hoffer and M. Troutman, “Managing Catastrophe — Managed Care Reinsurance Market Trends and Catastrophic Medical Claims Developments,” Contingencies, March/April 2018, available at <http://contingencies.org/managing-catastrophe-managed-care-reinsurance-market-trends-catastrophic-medical-claims-developments/> (last visited October 26, 2018).+(last+visited+October+26,+2018).+Excess+Medical+Reinsurance,+also+purchased+by+health+insurers,+functions+more+like+stop+loss+insurance,+providing+coverage+for+catastrophic+claims,+typically+those+that+exceed+$1+million.+For+a+more+detailed+discussion+of+these+products,+see+D.+Hoffer+and+M.+Troutman,+“Managing+Catastrophe+—+Managed+Care+Reinsurance+Market+Trends+and+Catastrophic+Medical+Claims+Developments,”+Contingencies,+March/April+2018,+available+at++(last+visited+October+26,+2018).>Google Scholar

This is a lower deductible than the national average, but is used for simplicity. See, for example, KFF, 2017 Employer Health Benefits Survey: Employee Cost Sharing (Sept. 19, 2018), available at <https://www.kff.org/report-section/ehbs-2017-summary-of-findings/> (last visited October 26, 2018), finding that the average deductible for a single insured in employer-sponsored plans is $1505.+(last+visited+October+26,+2018),+finding+that+the+average+deductible+for+a+single+insured+in+employer-sponsored+plans+is+$1505.>Google Scholar

These claims are increasing, however. In California, there was one child who apparently cost the state Medicaid program $21 million, Karlamangla, S., “One child, a $21-million medical bill: How a tiny number of patients poses a huge challenge for Medi-Cal,” Los Angeles Times, July 16, 2017, available at <http://www.latimes.com/politics/la-me-21-million-patient-20170716-story.html> (last visited October 26, 2018). Of particular interest here, Wellmark Blue Cross in Iowa disclosed paying $1 million a month for a young boy with hemophilia complications in 2017 and used that case as a reason to exit the marketplace, though it was highly unlikely the company did not have a reinsurance policy that would pay for his care. See T. Leys, “Iowa Teen's $1 Million-Per-Month Illness No Longer a Secret,” USA Today, May 31, 2017, available at <https://www.usatoday.com/story/news/nation-now/2017/06/01/iowa-teens-1-million-per-month-illness-no-longer-secret/360919001/> (last visited October 26, 2018). (last visited October 26, 2018).' href=https://scholar.google.com/scholar?q=These+claims+are+increasing,+however.+In+California,+there+was+one+child+who+apparently+cost+the+state+Medicaid+program+$21+million,+Karlamangla,+S.,+“One+child,+a+$21-million+medical+bill:+How+a+tiny+number+of+patients+poses+a+huge+challenge+for+Medi-Cal,”+Los+Angeles+Times,+July+16,+2017,+available+at++(last+visited+October+26,+2018).+Of+particular+interest+here,+Wellmark+Blue+Cross+in+Iowa+disclosed+paying+$1+million+a+month+for+a+young+boy+with+hemophilia+complications+in+2017+and+used+that+case+as+a+reason+to+exit+the+marketplace,+though+it+was+highly+unlikely+the+company+did+not+have+a+reinsurance+policy+that+would+pay+for+his+care.+See+T.+Leys,+“Iowa+Teen's+$1+Million-Per-Month+Illness+No+Longer+a+Secret,”+USA+Today,+May+31,+2017,+available+at++(last+visited+October+26,+2018).>Google Scholar

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