Aaron Albaugh peers out from under the brim of his cowboy hat, surveying the acres of hay fields in front of him. The fourth-generation rancher is raising about 450 cattle this year, in this remote corner of Lassen County, California.
His closest neighbor lives a half mile away. “And that’s my brother,” Albaugh says.
“If I want to go see a movie, it’s 70 miles, round-trip,” he adds. “If I want to go bowling, that’s 100 miles, round-trip.”
Living a half day’s drive from civilization, you learn to do without, he explains. If your refrigerator breaks, you put your food on ice until the weekend when you can go buy a new one. With health care, it’s the same thing.
“Put a Band-Aid on it,” Albaugh says. “I was raised: ‘You don’t need to cry’ and ‘Suck it up, buttercup.’ That’s the way I still live, and I try to treat my kids the same way.”
When people are already used to doing without health coverage, it’s particularly annoying to have the government say you have to buy it, say Albaugh and many of his neighbors in Lassen, Modoc and Shasta Counties.
While Obamacare is largely viewed as a success in California – the state marketplace, Covered California, is one of the most financially stable in the country – it has not worked as well for folks in this rural, northeast corner of the state.
There are two insurers selling plans in each county here, but residents say that has not created enough competition to bring down prices. Plus, many doctors these residents are used to seeing don’t take the marketplace plans.
“Being told you have to have insurance you can’t afford, and then that doesn’t cover what you need? You are stuck,” says Modoc County resident Althia Cline, who decided to forego coverage – and a surgery she needs to help with her asthma.Just like the movie theater and the bowling alley, most medical specialists are miles away. In Modoc County, there’s no hospital or birthing center where a woman can have a baby. Tessa Anklin, who lives in Canby, Calif., gave birth to her son and daughter over the border in Oregon, an hour and a half away from home.
Anklin makes about $33,000 a year as a dental receptionist. Her husband does seasonal work baling hay and herding cattle at local ranches. While their kids are covered by Medi-Cal, neither parent gets health insurance through work, and before the Affordable Care Act passed, Anklin and her husband did without coverage for a while.
Two years ago, they bought a plan through Covered California. Their monthly premium was just $2 a month after the ACA subsidy, but their deductible was $10,000.
“We paid for all of our medical services and our prescriptions,” she says. “We had no help until we reached the $10,000 deductible. So really, we had nothing.”
Then, last year, their monthly premium jumped to $600. The plan was the same, Anklin says, and their household income was the same. And they still faced the same hour and a half drive to see doctors they almost never needed.*
Anklin thought of all the other ways she could spend that money.