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

Capitol Public Radio interviewed Health Policy and Management assistant professor Dr. Dylan Roby about Californians who live near the state’s border and the difficulties they face when seeking out-of-state healthcare.
Tuesday, December 16, 2014
Diagnostic medical equipment hanging from wall mount
Capital Public Radio's Health Reporter Pauline Bartolone traveled to the town of Quincy, California, where major insurers Anthem Blue Cross and Blue Shield of California aren't covering routine out-of-state care. This is the first of a three-part series.
[Excerpt:] Dylan Roby, Assistant Professor at the UCLA Fielding School of Public Health, says it's fairly new that individual policyholders have trouble with out-of-state care. 

He says before the Affordable Care Act, some plans offered broad choice in doctors, and they controlled cost in other ways, such as refusing sick people. But Roby says consumer protections under the new health law have limited the ways insurers can cut spending.

“You saw plans having to figure out how to make money in the new world, where benefits were fairly fixed, they couldn’t have really high deductibles anymore, they couldn’t have annual benefit limits," says Roby. 
Roby says patients encounter limitations in doctor choice now because insurers are using provider payments as a budget-saving mechanism. 
"They basically just negotiated contract with lower cost providers, and so we’ve seen quite a few where the coverage is no longer as portable as it used to be," he says.

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