Skip to content
CapRadio

CapRadio

listen live donate
listen live donate
listen live
donate
  • News
    • News

    • State Government
    • Environment
    • Health Care
    • Race and Equity
    • Business
    • Arts and Lifestyle
    • Food and Sustainability
    • PolitiFact California
    News
    • News

    • State Government
    • Environment
    • Health Care
    • Race and Equity
    • Business
    • Arts and Lifestyle
    • Food and Sustainability
    • PolitiFact California
  • Music
    • Music

    • Classical
    • Jazz
    • Eclectic

    • Daily Playlist
    Music
    • Music

    • Classical
    • Jazz
    • Eclectic

    • Daily Playlist
  • Podcasts & Shows
  • Schedules
  • Events
  • Support
    • Support
    • Ways to support
    • Evergreen Donation
    • One-Time Donation
    • Corporate Sponsorship
    • Vehicle Donation
    • Stock Giving
    • Legacy Giving
    • Endowment Support
    • Members
    • Member Benefits
    • Member FAQ
    • Member Newsletter

    • Fund drives
    • Drawing Winners
    • Thank You Gifts
    Support
    • Support
    • Ways to support
    • Evergreen Donation
    • One-Time Donation
    • Corporate Sponsorship
    • Vehicle Donation
    • Stock Giving
    • Legacy Giving
    • Endowment Support
    • Members
    • Member Benefits
    • Member FAQ
    • Member Newsletter

    • Fund drives
    • Drawing Winners
    • Thank You Gifts
  • About
  • Close Menu
 We Get Support From:
Become a Supporter 
 We Get Support From:
Become a Supporter 

When A Marketplace Only Offers One Health Insurer

  •  Pauline Bartolone 
Thursday, December 18, 2014 | Sacramento, CA
Listen
/
Update RequiredTo play audio, update browser or Flash plugin.
  

As the Covered California open enrollment period continues, many people in Northern California find there is only one insurer available in the exchange. 

Dennie Wright lives in Indian Valley, a tiny alpine community at the northern end of the Sierra, close to the Nevada state border.

“We’re back in the back country you might say. But it is a beautiful place to live, and that’s why we choose to live here,” says Wright. 

Wright works as meat cutter in a grocery store, and lives in a modest home overlooking a green pasture. His zip code is one where Blue Shield stopped selling individual policies this year. Wright’s insurance agent told him he had only one insurance choice through the exchange.

“That was new to us, you know, Covered California. Anthem Blue Cross was the insurance carrier. Then of course, three months later I have a heart attack,” says Wright. 

Wright had a rough year – first it was the heart attack, then he was assaulted at work, and there were more heart-related emergencies. More than once, he was flown across the state line to Reno for care.

Indian -valley -3-p

Indian Valley is a tiny alpine community at the northern end of the Sierra. Pauline Bartolone / Capital Public Radio

Wright and his wife, Kathy, now have piles of medical bills and insurance denial letters. Anthem Blue Cross only covers emergencies out-of-state, not routine doctor care.  But Wright says travel to doctors in California, even though it is in his own state, is not as safe or as convenient as going to Reno.

He continues to see the Nevada doctors who put a defibrillator in his chest, and saved his life. State workers compensation and Anthem Blue Cross will pay for some of the bills, but the Wrights still don’t know if everything will be covered.

“One of the things they don’t want you to do is get stressed out," says Dennie Wright. "When you look at a bill like that, thinking it might not be covered, there’s nothing much more stressful than that.”

1214-Denniealone -p

Dennie Wright has a pile of medical bills and denial letters from his health insurance company. Pauline Bartolone / Capital Public Radio

There are other options for Wright, but not through Covered California. His insurance agent didn’t know another health plan was available, so Wright didn’t either. Although he didn’t need a subsidy, he was left in the same position as people in his zip code who need financial help to buy insurance. Covered California and Anthem were the only choice.  

“I mean, you should have some choices, especially if you’re going to have one that’s not going to cover you in the places you choose to go," he says.

Rural Northern California Insurance Problems Pre-Date the Affordable Care Act

Covered California Executive Director Peter Lee offered a different impression of choices in the marketplace last July.   

“In every corner of the state, consumers will have at least two plans to choose from, and in most areas, where most of the Californians live, they can choose between five or six plans,” said Lee during an event to announce the marketplace's 2015 plans and premium rates.

But information released for a Covered California board meeting his month suggest that's not true. In twenty-two counties in Northern California, there are zip codes where there is only one choice of insurer. 

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

Lee says now, the exchange is working to increase the range of choices in places where there are none. But he says the situation pre-dated the exchange.

"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," says Lee. 


Map Highlights Pricing Region 1 - Northern Counties

Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, Glenn, Humboldt, Lake, Lassen, Mendocino, Modoc, Nevada, Plumas, Shasta, Sierra, Siskiyou, Sutter, Tehama, Trinity, Tuolomne and Yuba counties

1217-pricing -region

Source: Covered California: Health Insurance Companies And Plan Rates For 2015


Lee says the exchange is encouraging existing plans to expand to areas where there are enough doctors.  And it’s looking to bring new carriers in for 2016.  

"We aren’t the solution to all the problems that have always been there in terms of challenges in rural communities, and that’s something we’re certainly looking at how to improve access and choice, and we’ll continue doing that," says Lee. 

Health consumer advocates agree: Covered California can have a powerful role in shaping insurance options. But Anthony Wright, Executive Director of Health Access says increasing choice in rural areas is not simple.

"Some of this is a combination of putting pressure on the insurers, and some of this is trying to do work to actually increase the number of providers on the ground in these areas, whether through more training, [or] incentives to be in some of these more rural areas," says Wright.

Wright says more insurers in the marketplace makes it more likely people can get the care they need.

“This is one of the reasons why we advocated for a public option, a public plan. Just like yes, you have UPS and FedEx, but you also have the United States Postal Service that goes everywhere and provides some guaranteed service to everybody," he says. 

"At one level, we’re trying to make a functioning market, but it still means that consumers are at the mercy of the market.”

This year, people who want more choice than what Covered California offers, must venture into the broader health insurance market if they can afford it.  

Click here to view a chart of the health insurance market share in Northern California.

Source: Covered California: Health Insurance Coompanies And Plan Rates For 2015


Follow us for more stories like this

CapRadio provides a trusted source of news because of you.  As a nonprofit organization, donations from people like you sustain the journalism that allows us to discover stories that are important to our audience. If you believe in what we do and support our mission, please donate today.

Donate Today  

    More about Few And Far Between

  • Few And Far Between: Health Insurance Choices In Rural Northern California

    In a three-part series, Capital Public Radio explores why rural northern Californians are facing new challenges with individual health insurance.

    Related Stories

  • Emergency Health Insurance Regulation Issued

    Monday, January 5, 2015
    The California Department of Insurance issued an emergency regulation today [Monday] intended to assure improved healthcare access to Californians.
  • Pauline Bartolone / Capital Public Radio

    After Blue Shield Pulls Out of Zip Codes, Consumers See Limited Insurance Options

    Wednesday, December 17, 2014
    Blue Shield of California stopped selling policies to individuals in 250 zip codes in 2014. The coverage area reduction is especially felt in Northern California, where consumers have few choices through Covered California.
  • Pauline Bartolone / Capital Public Radio

    California Border Residents Grapple with Out-of-State Health Insurance Restrictions

    Tuesday, December 16, 2014
    Anthem Blue Cross, the largest insurer in Covered California's Northern California region, ended an out-of-state benefit for individual planholders this year. Blue Shield of California plans in the region also restrict care to within state lines.

 healthhealthcarehealth insurancecovered californiaFew And Far Between

Pauline Bartolone

Former Editor-at-Large

Pauline’s been a journalist for two decades, covering health care, education and the many disparities that exist in California.  Read Full Bio 

More Stories

AP Photo/Chris Carlson, File

California Senate approves bill to limit police stops for headlights, expired registration

May 31, 2023

Andrew Nixon / CapRadio

Sacramento aims to reopen a public pool next summer. What do communities lose without access?

May 31, 2023

Steve Martarano / Solving Sacramento

WellSpace’s ‘Crib’ program provides temporary alternative to hospital or jail for unhoused people in crisis

May 30, 2023

We Get Support From:
Become a Supporter

Back to Top

  • CapRadio

    7055 Folsom Boulevard
    Sacramento, CA 95826-2625

    •  
      (916) 278-8900
    •  
      (877) 480-5900
    •  Contact / Feedback
    •  Submit a Tip / Story Idea
  • About

    • Mission / Vision / Core Values
    • Stations & Coverage Map
    • Careers & Internships
    • Staff Directory
    • Board of Directors
    • Press
  • Listening Options

    • Mobile Apps
    • Smart Speakers
    • Podcasts & Shows
    • On-Air Schedules
    • Daily Playlist
    • Signal Status
  • Connect

    •  Facebook
    •  Twitter
    •  Instagram
    •  YouTube
  • Donate

  • Listen Live

  • Newsletters

CapRadio stations are licensed to California State University, Sacramento. © 2023, Capital Public Radio. All Rights Reserved. Privacy Policy | Website Feedback FCC Public Files: KXJZ KKTO KUOP KQNC KXPR KXSR KXJS. For assistance accessing our public files, please call 916-278-8900 or email us.