Rural Californians lack choice under the ACA

NPR reported last week on the lack of choice that many rural northern Californians face under the Affordable Care Act.  Here's an excerpt from Pauline Bartolone's story, initially done for the NPR affiliate in Sacramento.

[I]n 22 counties in Northern California, there are ZIP codes where there is only one choice of insurer, even if that company offers a few different plans. There are areas around Monterey and Santa Cruz on California's central coast that also have only one carrier. 

Blue Shield of California said it had to stop selling individual plans in areas that didn't have a hospital contracted with Blue Shield. The insurance firm said it had offered doctors in those areas rates of payment that would keep premiums low, but not all doctors accepted the payment terms. 

Covered California estimates that statewide, there are 28,896 Covered California customers who have only one choice of insurance carrier—slightly over 2 percent of the total exchange membership as of November 2014.

The map shows the places in northern California where residents have only one option under Covered California.  Places around Monterey and Santa Cruz that face the same challenge are no shown on this map.

Peter Lee, Executive Director of Covered California, had announced in July, 2014, that all Californians would have at least two choices of health care plans.  Now, however, he notes that the problem predated the exchange.  Lee also commented:

The challenges of northern, rural counties have been there for a long time and are still a challenge that we're trying to address head-on.

For now, these rural residents are shortchanged in terms of affordable access to a highly critical need:  health care.