WaPo: No, you can’t keep your doctor or your hospital in ObamaCare
posted at 8:41 am on November 21, 2013 by Ed Morrissey
The collapse of the “if you like your plan, you can keep your plan” pledge has outraged millions of Americans who got cancellation notices from insurer over the last few weeks. The second part of that pledge, in which Barack Obama promised that those who liked their providers would not be forced to switch, is just as false, reports the Washington Post today. In the latest belated media discovery about the cost-containment mechanisms of ObamaCare, the Post notes that a gap has now opened on provider access between individual and group plans that didn’t exist before:
As Americans have begun shopping for health plans on the insurance exchanges, they are discovering that insurers are restricting their choice of doctors and hospitals in order to keep costs low, and that many of the plans exclude top-rated hospitals.
The Obama administration made it a priority to keep down the cost of insurance on the exchanges, the online marketplaces that are central to the Affordable Care Act. But one way that insurers have been able to offer lower rates is by creating networks that are far smaller than what most Americans are accustomed to.
The decisions have provoked a backlash. In one closely watched case, Seattle Children’s Hospital has filed suit against Washington’s insurance commissioner after a number of insurers kept it out of their provider networks. “It is unprecedented in our market to have major insurance plans exclude Seattle Children’s,” said Sandy Melzer, senior vice president.
The result, some argue, is a two-tiered system of health care: Many of the people who buy health plans on the exchanges have fewer hospitals and doctors to choose from than those with coverage through their employers.
A number of the nation’s top hospitals — including the Mayo Clinic in Minnesota, Cedars-Sinai in Los Angeles, and children’s hospitals in Seattle, Houston and St. Louis — are cut out of most plans sold on the exchange.
Welcome to Government Insurance! Hey, you didn’t really need a top-flight surgeon for your condition anyway. Maybe you should just take a pill.
That’s not really an option for Jeffrey Blank, whose daughter has a rare bone disorder. Childrens Hospital of Seattle had been managing her case for a while, but now his new (and improved!) ObamaCare-driven plan won’t pay for the visits. The need to hold costs down as higher-risk members flood into the risk pools forced insurers to concentrate on community hospitals rather than specialty hospitals and providers, and that means that millions of people who have had an ongoing and successful relationship with their providers will have to start all over — and hope that it doesn’t make their situation worse.
It’s not just the hospitals, either. McClatchy and Kaiser Health News report that doctors are balking at the new reimbursement schedules, too, and may opt out of exchange-based plans:
Many doctors are disturbed that they’ll be paid less – often a lot less – to care for the millions of patients who are projected to buy coverage through the health law’s new insurance marketplaces.
Some have complained to medical associations – including those in Texas, California, Georgia, Connecticut and New York – saying the discounted rates could lead to a two-tiered system in which fewer doctors participate, perhaps making it harder for consumers to get the care they need.
“As it is, there is a shortage of primary care physicians in the country, and they don’t have enough time to see all the patients who are calling them,” said Peter Cunningham, a senior fellow at the nonpartisan Center for Studying Health System Change in Washington.
If providers are paid less, he said, “Are (enrollees) going to have difficulty getting physicians to accept them as patients?”
Before ObamaCare, of course, insurers, doctors, and patients could make that decision on their own. Silly patients! Thanks to Barack Obama, now we can all be free to not get service from the people who really know us and our conditions, and get forced into community care instead.
None of this is news, actually. Republicans have warned about this for years, and even the New York Times figured it out by September. CNN reported on the White House anxiety over this more than two weeks ago. Perhaps it would have helped if these media outlets had been more curious about the cost-saving claims of ObamaCare in, oh, 2009.
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