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In some rural counties the decline in marketplace enrollment was as much as 36 percent in 2017. (Photo: Shutterstock)

Ms. Stella’s, a home-cooking restaurant in Milledgeville, Ga., serves roast beef, grilled pork chops, chicken wings and oxtails with 24 sides from which to choose. Last spring, owners Jeri and Lucious Trawick opened a second restaurant in Eatonton, about 20 miles away, and Jeri decided to leave her full-time job to help shepherd the expansion.

But she needed to update the couple’s health insurance and went shopping on the Affordable Care Act’s online marketplace. Trawick, 43, who considers herself nearly as skilled with a computer as she is with a skillet, found the Obamacare website daunting.

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