For people living in some parts of the state, they are not seeing the selection that they feel they were promised.
When Peter Lee, the executive director of Covered California, spoke about the health insurance exchange in the state, last July, he gave the impression that Californians would be able to use the marketplace to purchase their plans and would always have at least two plans from which to choose.
However, depending on where they live, this is not always the case for many people across the state.
Lee’s announcement of the 2015 plans and health insurance premium rates stated that “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.” While this has been more than true in some places – particularly those that are the most densely populated – other regions have found that this is far from what they are actually seeing. For instance, almost half of the members of the exchange and who live in Northern California have only one option available to them.
Within 22 Northern California counties, there are ZIP codes in which only one health insurance company is available.
While it can be said that that one insurer may offer more than one plan, the options available to residents in those area allow them to do business with one insurance company, only. This is not exclusive to Northern California. For example, in the central coast region of the state, Santa Cruz and Monterey also have only one carrier from which to choose.
This was primarily the result of the withdrawal of Blue Shield from selling through Covered California. The insurer explained that it had to stop selling its individual health plans within those areas because those were places where there weren’t any hospitals that were contracted with them. It said that it did make rate of payment offers to doctors in those areas that would help them to keep their premiums down, but not enough doctors were willing to accept those payment terms in order to make it viable for the insurer.
It has been estimated by the health insurance exchange that there are 28,896 customers of Covered California that have only one choice of insurance company open to them. Based on November 2014 figures, that represents just over 2 percent of the total membership of that marketplace.