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.

That’s why those who live in areas with limited options should not be subject to the $695 penalty for forgoing insurance, the group says.

“For rural residents there are fewer choices, and higher costs. A choice of one is no choice at all,” says CEO Jeff Smedsrud. "The health insurance marketplaces were established to create competition to help curb costs. While this is working for urban dwellers, it is not working for rural residents. Why should they pay a penalty if they don't buy what is being force-fed to them?"

Instead, says Smedsrud, the self-employed in rural areas should be allowed to buy short-term health insurance, which does not count as a qualifying policy under the PPACA.

“Rural Americans who purchase their own health insurance should not be mandated to buy coverage without choice,” he adds. “By waiving the tax penalty, they can select health insurance coverage from numerous short term medical insurance carriers at a price they can afford.”

While there has been no shortage of outrage over the prices charged for Obamacare plans, studies have also showed that many who have forgone insurance are unaware that they are often eligible for hefty subsidies to offset the sticker price. Many, in fact, are even eligible for practically free coverage through Medicaid.

Instant Insights /

Should some rural areas be exempt from PPACA mandate?

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