Enough insurers are planning to sell coverage on the Affordable Care Act’s insurance exchanges next year to keep them working – if only barely – in most parts of the country.

Competition in many markets has dwindled to one insurer – or none in some cases – and another round of steep price hikes is expected to squeeze consumers who don’t receive big income-based tax credits to help pay their bill.

“What we’re seeing is a deterioration in these markets, but the markets haven’t imploded, they haven’t gone into a rapid downward decline,” said Dan Mendelson, president of the consulting firm Avalere.

Health insurers had until Wednesday to declare whether they planned to sell coverage next year on exchanges in most states. Actual participation and final rates won’t be set until late summer or closer to the Nov. 1 start of enrollment for next year’s coverage.

Early plans filed by many insurers for next year include premium increases well over 20 percent, and Avalere expects more than 40 percent of U.S. counties to have only one insurer selling coverage on the exchange. Some counties in Missouri, Ohio, Indiana and Washington will have none if another insurer fails to step in.

The early picture for 2018 looks much like it did for previous years: Insurers are retreating from some markets or charging a lot more to stay in others.

The Blue Cross-Blue Shield insurer Anthem said Wednesday that it will leave exchanges in Wisconsin and its home state of Indiana. This comes a few weeks after the nation’s second-largest insurer also said it was pulling out of Ohio’s exchange.

Nationwide, prices for individual insurance could rise between 28 and 40 percent on average, according to a prediction by Oliver Wyman Actuarial Consulting.

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