Guam, Puerto Rico, American Samoa, the USVI & NMI are off the ACA hook
As I noted way back in October (seriously, I made a note of it at the bottom of the spreadsheet the very first week), the ACA situation in Guam, American Samoa, Puerto Rico, the U.S. Virgin Islands and the Northern Mariana Islands is, to put it mildly, kind of screwed up. Due to some massive oversights, they were stuck with some of the ACA's provisions (no denials for pre-existing conditions, having to accept everyone, etc.), but didn't get the other key provisions (no exchanges, no subsidies). As a result, it's been a bit of a mess.
Thankfully, the problem has been "solved", although not quite the way the Obama administration intended:
Guam and the four other American territories got some good news this week: they will no longer be held hostage by a byzantine set of Obamacare rules and regulations.
In letters sent July 16, the Obama administration notified territorial regulators that their residents would be largely exempted from health law requirements. The decision was meant to settle a months' long dispute between insurance regulators and the White House over how Obamacare effects American territories, which had made a mess of their insurance markets.
...In other words: instead of getting partial-Obamacare, which really screwed up the territorial insurance markets, the territories are essentially getting no Obamacare.
The Obama administration now plans to issue regulations that say insurers selling coverage in the territories don't have to accept all customers, as those selling in American states do. Territorial insurance plans will no longer have to cover the essential benefits package, nor will they be subject to the "80/20 rule," which requires health plans to spend at least 80 percent of premiums on medical costs.