This new year, perhaps we should all resolve to model the spirit of SLO, the acronym that embodies San Luis Obispo, perhaps the easiest place in California to catch your breath and get a little rest.

SLO has been central to my own coping strategy during this miserable COVID year. Whenever work pressures or distance learning horrors or home confinement makes our family feel like we’re going insane, the five of us take our 2006 Toyota Scion three hours north from L.A. to some empty and beautiful spot in that empty and beautiful county. So far, we’ve taken five short SLO breaks of three or four days each.

In pursuing this strategy of escape, we’ve been exploiting not only extreme pandemic discounts on lodging, but also a geographic and metaphorical truth about California. The Golden State is loudest and most exhausting at its extremes and on its geographic edges, where most Californians live. If you want to find more room, and a little solitude and peace, you should look to the state’s middle.

The paradox of San Luis Obispo County is that it feels like a place apart precisely because it’s centrally located. The Cal Poly historian Daniel E. Krieger called it California’s “Middle Kingdom,” with a nod to Tolkien. In this Middle-earth, both San Francisco and L.A. hold sway but neither dominates; electricity comes from PG&E in the north, and gas from Southern California Gas.

And this middle identity runs deep. San Luis Obispo was the middle mission in the chain of Franciscan missions, and the place where coastal rail links to the north and south finally met in 1901. SLO also takes middling pride in having invented the motel in 1925, with the opening of the Milestone Mo-Tel, which served middle-class vacationers who couldn’t afford finer lodging but wanted a cheap place to stop and sleep on long coastal drives. (Eventually renamed the Motel Inn, it closed in 1991, but there are plans to redevelop the site with guest rooms and a restaurant.)

Today, San Luis Obispo County retains a decidedly middle-class vibe, amidst the rich-and-poor extremes of 21st-century California. SLO incomes are a little lower and costs, while still too high, are less than in many other parts of the coast. Its politics, while trending left, are middle of the road by California standards.

While SLO County may be small in people—with just 283,000 residents, or about as populous as the San Diego suburb of Chula Vista—it retains a big sense of itself. In recent weeks, its elected officials and media protested the state’s new stay-at-home order, which put the county in the “Southern California region” along with counties as distant as Riverside and Imperial. The San Luis Obispo Tribune editorialized, with fervor unusual for SLO, that “If Gov. Gavin Newsom doesn’t want a full-scale rebellion,” he’ll recognize the Central Coast as its own region.

Most of the time, San Luis Obispo, rather than a place for revolt, is an escape from the permanent revolutions of life in our urban regions. I’ve loved the place since childhood, when my family stopped there on frequent drives from the San Gabriel Valley to see my grandparents in the Bay Area. As an adult, I’ve dreamed of vacations on the super-cool SLO coast during hot L.A. summers, but summertime SLO hotel and motel prices were too much for a nonprofit journalist. Until the pandemic hit.

We first snuck away one sweltering July week when it was 100-plus in Southern California, and 62 on a hill outside Cambria, where a motor lodge with summer rates often above $400 a night was offering rooms for $99. Social distancing was easy—the lodge didn’t have indoor hallways, and there was hardly anyone around, making it far more COVID-safe than our dense L.A. County community. Even just a few days there felt restorative—mental health therapy far cheaper and more effective than any shrink.

We certainly haven’t become SLOcals. We don’t drink wine or have a taste for olallieberries. And try as we might, we don’t quite understand the boomer-vs.-millennial debate over whether this glorious place should be called “San Louie” or just plain SLO.

But we’ve come to appreciate the different worlds of the Middle Kingdom. There’s no denying the sun-splashed beauty of the Five Cities area (from Pismo Beach to Oceano), and the pleasures of splashing in the creek that runs under downtown San Luis Obispo, before emerging at Mission Plaza. I’ve been so impressed by Cal Poly, an unfussy educational treasure with the best graduation rates in the Cal State system, that I dream of sending my science-minded oldest son there.

Still, those are all South County places, and we’ve learned that we prefer to spend time “over the grade”—that is, above the steep Cuesta Pass that divides North from South in SLO. We’re partial to the North County’s oak trees and gardens, to drives along Highway 46, to the Mexican food and mini-golf in Atascadero, and to the cookies and coffee in Cambria.

For me, the least stressful day of a very stressful 2020 came on the cold late summer afternoon when I left my wife to her work and the kids to online lessons, and walked alone for a couple miles along the beach at San Simeon State Park. My eyes delighted in the landscape—looking over the coast, out to sea, and then up at Hearst Castle, closed for COVID. For two hours, in the middle of California, this middle-aged newspaperman didn’t see a single other person, and imagined the Middle Kingdom was his own.

I walked as SLO-ly as I could.

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Part of my job is to understand the complicated, and I’ve never come across anything as complicated as the Affordable Care Act. As I studied it after its passage in 2010, I began to worry about how the law’s one-size-fits-all approach would work in a semi-rural county where the major industries are agriculture, tourism, and government. I became concerned that no one here in San Luis Obispo could explain the law to me. And when I trained insurance agents on the law, I saw their eyes glaze over. New and experienced agents couldn’t make sense of the subsidies, plan eliminations, limited enrollment periods, and new taxes. Many agents chose not to participate in the new system, or to get certified to sell policies through Covered California.

I saw all this confusion as an opportunity—to give back to my community and to educate the individuals and businesses that have been so loyal to me and my insurance agency, even after I turned it over to my wife and went to work in management at Anthem Blue Cross. So I left that management position—and a salary and great benefits—and decided to take on the task of educating our community on healthcare reform.

Getting the word out through traditional advertising was beyond my financial means. So I began meeting with people from local institutions and found that my most promising partners were hospitals. I prepared elaborate presentations about the risks and rewards of Obamacare. Hospital staff and executives were as puzzled as anyone else about the impact of the law and had a financial interest in public education. I offered to provide that education and, in turn, the hospitals agreed to use their media and community contacts to spread the word about my willingness to educate people on the subject.

The invitations started to pour in. I gave joint presentations with the county health department on the Medi-Cal expansion that’s part of Obamacare. I spoke at the chamber of commerce, the rotary, and other service and community organizations. Many churches in the region offered the use of their rooms and did outreach. Through word of mouth, I had gained enough momentum to launch a public campaign.

I launched the campaign last June—four months before open enrollment for Obamacare was set to begin—with the help of the health department, hospitals, churches, and other community organizations. My first seminars at Sierra Vista Regional Medical Center and Twin Cities Regional Medical Center were attended by about 50 people each, about half of what I expected. Most of the people who attended were either fearful of losing their Medicare coverage or community leaders who had insurance but were trying to understand the new law. Very few people who the law was designed to help—the uninsured—showed up. Even after we modified the ads to attract young people and those without coverage, very few members of our target population attended. By the enrollment launch in October, I had conducted 23 publicly advertised seminars in every corner in San Luis Obispo County, but the total attendance was only 500.

Given this lack of engagement, and the considerable confusion, I worried about the launch of the Affordable Care Act. And unfortunately, the botched rollout made it clear that San Luis Obispo was not unique: Many people in state and federal governments who were in charge of rolling out the new law did not understand it either.

I found it particularly frustrating to hear officials describe the process as easy. Peter Lee, executive director of Covered California said that using the website would be as easy as “buying a book on Amazon or a pair of shoes on Zappos.” Public statements were made about how small businesses could buy the same plans as large corporations, see their insurance prices fall, and get tax credits for offering coverage. These statements have proven to be untrue. Even worse, they made my local efforts at public education much more difficult.

As we now know, the Covered California website—while better than the federal exchange site and other state exchange sites—was only marginally functional for the first three months. Clients who turned to the phone often found the lines jammed; those who got through waited for two hours or more. People were extremely frustrated.

Even after all those months of work and public education, I couldn’t do much to help people. We agents were getting the runaround, too. First, we were told to use the website, which was unreliable. In December, we were told to use paper applications, but the fax lines were often down. Then we were told that Covered California didn’t have the capacity to enter the faxed information into the system and that we would have to enter it ourselves.

Communication between Covered California and the insurance companies was very poor. Many people who tried to sign up didn’t realize that Covered California was just a conduit for collecting information and validating income before an application was turned over to the insurance company to generate an invoice. There were long delays and repeated requests by Covered California for information that we had already submitted for clients. Numerous time extensions were issued, some of which Covered California did not honor. A client would be promised coverage effective January 1 but instead would be issued coverage a month later.

The good news is that final enrollment numbers in California exceeded expectations. People with a pre-existing medical condition can now buy individual coverage at standard rates. The expansion of Medi-Cal has made coverage more affordable to low-income people, and the subsidies helped many people buy higher benefit plans at low premiums. There were a few rewarding moments: the 64-year-old cancer patient without coverage who I pushed through the system so she could start cancer treatment within days of January 1. The widow who attended one of my seminars who cried when I showed her that she would have very low premiums and good benefits.

Unfortunately, such stories were the exception in my experience. Most of the people I worked with were already insured. They were reapplying to obtain lower premiums through the subsidies—beneficial, but not an expansion of coverage. Less than 20 percent of the folks I enrolled were uninsured. Other local agents I know experienced the same thing.

I’m also not seeing the choice and competition among health plans that was supposed to happen. In San Luis Obispo County, only two companies were available to individuals through Covered California: Blue Cross and Blue Shield, both of which previously dominated the market. Before Obamacare, there were three other small plans and dozens of options and prices. There are only four options offered under Covered California and, in many cases, my clients are actually paying more. And, because the reimbursement rates remain so low, some physicians won’t accept the new plans. Healthcare coverage is an illusion if no one will provide you with care.

It wasn’t any better for my business clients: the Small Business Health Options (SHOP) exchange only included Blue Shield and Health Net. The law only offered the much touted tax credit to businesses that went through the exchange, but many other carriers—and the most desirable plans—were offered outside the exchange.

After these last few years of studying and working with the law, I’m convinced that Obamacare was well-meaning but attempted to do too much, too fast. Of course, the continuous opposition and repeal attempts have hampered progress, but the lack of preparation and confusion is still inexcusable.

I remain worried about whether major problems will be addressed by the next open enrollment, which has been delayed until November 15. I continue to see clients whose information still has not been updated, or whose applications for insurance are listed as “pending”—even though they were approved months ago. The forms and website need to be clarified, so people don’t make mistakes. There’s still too much confusion out there. But, as an eternal optimist, I will continue to try to educate my community on how to deal with this ever-changing, but very important, legislation.

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