Blue Shield is pulling out of Monterey County, a region in which it was expected to provide coverage to individuals under the Affordable Care Act.
Blue Shield cited a lack of providers willing to accept its compensation rates. The state Legislature considered several bills this year seeking to ease the physician crunch.
“We could not get providers to agree to more reasonable rates, and therefore we chose to exclude Monterey County from our Exchange filing,” Blue Shield spokesman Steve Shivinsky told the Californian.
The number of doctors and hospitals willing to accept reimbursement rates is emerging as an important concern as the health exchange readies to open for business Oct. 1.
Covered California had not updated its rate plan booklet to reflect the news as of Sept. 18, and it continued to show Blue Shield as a health insurance carrier for Region 9, which also includes Santa Cruz and San Benito counties. The Blue Shield spokesman said health coverage for individuals would be available in the other areas of Region 9.
Covered California, the state health insurance exchange under Obamacare, offers coverage in 18 regions, but with a changing cast of insurance providers depending on the area. Region 9 will have any two carriers in Monterey County, Anthem and Health Net, according to the Covered California health plan guide.
Gov. Jerry Brown has signed off on a plan to speed up the licensing of doctors who agree to practice in underserved areas. Another plan would allow pharmacists to take on a limited number of duties previously handled by doctors, such as ordering tests.
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