As the Obama administration tries to ratchet up the pressure on the millions of Americans who have still avoided buying health insurance, one advocacy group says it should carve out a big exemption for those who live in areas where there aren’t many insurance options available.

Research has shown that in more than 650 counties across the U.S., there is only one carrier offering plans through the Patient Protection and Affordable Care Act (PPACA) marketplace.

As a result, says Communicating for America, a self-described advocacy group for the self-employed in rural areas, millions of Americans don’t have a real choice when it comes to health care.

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