The Associated Press first reported this developing and completely predictable problem earlier in the week. What happens when you pass a law that (a) causes the health-insurance cancellation for millions and then (b) forces them and millions more to use a disastrously-built web portal as a middeman to replace that coverage? Answer: You end up with millions of people flooding into providers without any idea whether they have coverage or whether their doctor will accept it.
The New York Times confirmed this issue … for its Saturday edition, of course:
In addition to the difficulties many face in proving they have coverage, patients are also having a hard time figuring out whether particular doctors are affiliated with their health insurance plan. Doctors themselves often do not know if they are in the network of providers for plans sold on the exchange.
But interviews with doctors, hospital executives, pharmacists and newly insured people around the country suggest that the biggest challenge so far has been verifying coverage. A surge of enrollments in late December, just before the deadline for coverage to take effect, created backlogs at many state and federal exchanges and insurance companies in processing applications. As a result, many of those who enrolled have yet to receive an insurance card, policy number or bill.
Many are also having trouble reaching exchanges and insurance companies to confirm their enrollment or pay their first month’s premium. Doctors’ offices and pharmacies, too, are spending hours on the phone trying to verify patients’ coverage, sometimes to no avail.
“The system wasn’t really built to handle this kind of glut of new patients,” said Dr. Curtis Miyamoto, a radiation oncologist at Temple University Hospital who is president of the Philadelphia County Medical Society. “So it’s resulting in us having some delays in getting people verified, and therefore delays in their care.”
That’s leading to decisions like this being forced on the once-insured:
In Langley, Wash., north of Seattle, Erin Waterman was able to see a primary care doctor on Jan. 3 with a temporary identification card printed from the website of her new insurer, LifeWise Health Plan of Washington. But when Ms. Waterman, 47, tried to fill a prescription for a new asthma inhaler, the pharmacy could not verify her coverage even though she had paid her first month’s premium on Dec. 23.
Ms. Waterman was given the option of paying full price — $187, instead of the $50 co-payment required under her new plan — and eventually being reimbursed. But she decided to wait, and hope that she does not have an asthma attack in the meantime.
By the way, asthma attacks can kill. In 2010, asthma attacks killed over 3400 Americans, according to the CDC.
Be sure to read it all. This issue extends well beyond whether an enrollment has been successfully concluded. As mentioned above, providers themselves aren’t even sure whether they’re in network on which plans, which means that their ability to get reimbursement is under question on every patient that comes through on anything other than a group plan. And even if they know that, providers aren’t sure which procedures and treatments will be covered, thanks to a massive amount of confusion over the mandates in ObamaCare.
This, of course, is just the appetizer. When the employer mandate hits this fall, it will similarly scramble the coverage of tens of millions of Americans who end up in the ObamaCare exchanges when their employers simply decide to opt out of subsidizing the rapidly-escalating premiums in health insurance, and we’ll get a crisis orders of magnitude larger one year from now.
With that in mind, Sen. Thad Cochran called for a New Year resolution to repeal ObamaCare in the GOP’s weekly address to the nation yesterday, and questioned the honesty and integrity of the White House and its statistics on “enrollments”:
“The Affordable Care Act was supposed to be fully operational by January 1 of this year, but here we are two weeks into 2014, and the administration continues to struggle to implement the law’s burdensome mandates,” Cochran said in theweekly Republican address. “The law is not living up to the promises made by its supporters, and it is questionable whether the law will meet its fundamental purpose – to significantly expand health insurance coverage.”
The administration and congressional Democrats have recently been touting the law’s expansion of coverage to roughly nine million Americans – three million young adults who have been able to stay on their parents’ plan, two million consumers who have enrolled in the private insurance exchanges and four million low-income consumers who have been inducted into an expanded Medicaid program.
Cochran, however, argued there may be less to those figures than meets the eye.
“The administration’s enrollment numbers don’t paint a pretty picture,” he said. “They don’t tell us how many of the enrollees have actually lost existing coverage and were forced into the exchanges; and the numbers don’t tell us whether applicants have actually paid their premiums and received coverage. There is ample reason to be skeptical that those numbers will improve substantially.”
Cochran’s other complaints about the law had a familiar ring: that it’s booting people off of health plans they liked despite the president’s promise that people could keep their current insurance; that it’s forcing people to change doctors; that many consumers are finding their prices going up under Obamacare.
“If the law can’t keep its most basic promise, it should be repealed,” he concluded. “We should go back to the drawing board and draft commonsense, bipartisan legislation that will work better for all Americans, without spending billions of taxpayer dollars to support these failing policies.”
Let’s hope we don’t have to make this New Year’s resolution again for 2015.