Video: ObamaCare enrollee can’t get doctor to see her

posted at 3:21 pm on February 20, 2014 by Ed Morrissey

CBS affiliates bring us two updates on the ongoing disaster of Covered California, the ObamaCare exchange in the Golden State that has begun to look a lot more like Uncovered Californians. In Sacramento, Nick Janes reports on the plight of Katherine Cadman, who eagerly signed up for an insurance policy through the state’s exchange — and then tried to use it to see a doctor. Doctors, however, are not anxious to see customers from ObamaCare plans, thanks to the lousy reimbursement rates:

One viewer said she did months of research before picking the plan that Blue Cross recommended. But it’s still been a nightmare.

Katherine Cadman says her emails and calls aren’t getting anywhere. She says she signed up for an Anthem Blue Cross Plan, but doctors keep refusing to see her.

“It’s just not right,” she said. “It does make you feel like you’re a second-class citizen.”

Chris and Tammy Dunn told us the same exact thing about their experience trying to find a doctor to fix Chris’ back. He says an in-network doctor turned him down.

“I haven’t slept in four months,” said Chris.

When we again reached out to Anthem again for answers on Wednesday and they issued the following statement:

“Our records indicate that this doctor has a contract with Anthem Blue Cross to treat our Covered CA members, and we will reach out to him to determine what the issue is.”

The doctor apparently was on the plan … emphasis on the past tense. The providers in question decided not to provide service under the reduced reimbursement rates that Anthem’s ObamaCare-compliant plan delivers. That’s his choice; doctors don’t have to accept insurance plans, after all, especially if the reimbursement doesn’t cover his or her costs to provide services. That, however, leaves Covered California consumers asking this question:

“What are we left with as far as being Covered California subscribers?” Cadman asked. “The bottom of the barrel?”

When payments get cut to bottom-of-barrel rates, what do consumers expect to happen?

In the San Francisco area, they’re discovering that the doctors that will accept them work in areas they’d rather not visit:

California’s health care exchange promised potential customers they would have enough physicians to choose from. But some new enrollees, including an Alameda County woman, are discovering that their doctor choices are extremely limited.

Julia Turner is surprised that she even has to search for a doctor. When she signed up for a policy through Covered California late last year, her long-time physician was listed as participating in her Blue Shield plan. It turned out; however, that he is not accepting patients with her Blue Shield policy, purchased on the Covered California exchange.

When Turner called around to find someone else to treat her, she got more frustration. “The only doctors accepting new patients are urgent care clinics,” Turner told KPIX 5 ConsumerWatch.

None of the doctors are located in the city in which she lives. Instead, Turner said, “They are in areas of East Oakland that have a lot of violence.”

Only one doctor on the Blue Shield list for Turner’s plan in her area was both board-certified and accepting new adult patients … out of 41 listed. KPIX got Blue Shield to add her existing doctor into the network, but Turner isn’t happy with the outcome:

“This is not what we were promised. I see those (Covered California) commercials now and I want to scream,” Turner said.

Yes. You were promised a free lunch, and expected that to be realistic. The laws of supply and demand, and cost and pricing, do not get wished away or legislated out of existence.

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A rare outcome, -it means you live in an already highly (over-) regulated state like California or New York, and you are 40 or older.
slickwillie2001 on February 20, 2014 at 8:39 PM

Very good, you are correct. And I have maintained coverage since 1997.

Constantine on February 20, 2014 at 8:58 PM

Ah, so your “compassion” is “I got MINE, so go away”?

How is your “compassion” here different from me taking someone else’s winter coat? Now I’m warm and he’s freezing… but I’m better off so it was a move of compassion?

What part of compassion involves screwing over the majority financially so you personally can do better?

gekkobear on February 21, 2014 at 3:01 PM

Directive 10-289 coming soon to a socialist state near you.

To deal with this temporary difficulty, doctors who normally charge higher prices will have their fees cut to the national average, while those who charge less will receive subsidies. This is being done to equalize the medical care system, and give the less fortunate doctors a more fair opportunity.

For the duration of the unexpected hardship, hospitals and doctors will not be allowed to refuse care to anyone, except the rich who can afford the best care, who will not receive care until all less fortunate patients are seen, increasing the fairness of healthcare.

It is universally understood and agreed by all non-greedy citizens that these measures are proper and critically necessary to deal with the current crisis.

Thank you for your voluntary participation.

Freelancer on February 21, 2014 at 3:56 PM

I can’t imagine how anyone with any experience balancing their checkbook could have thought this was going to turn out any differently than it is…

oh, wait… nvm…

— Smoov

Smoovious on February 21, 2014 at 7:22 PM

Will Obamacare be repealed or won’t it? Will Congress fund it or won’t it? Will the web site be fixed or not? Blah, blah, blah. We the people just need to do what we need to do and Congress be damned. Resist. Refuse. Revolt. EXEMPT OURSELVES!

devan95 on February 21, 2014 at 10:24 AM

great post. Correct. Nobody needs to sign up. They pretty much admitted that the IRS won’t be able to collect.

As we see, your premiums will not allow you to see a doctor anyway, so you have a breach of contract case. Lawyers are standing by, waiting for your calls.

virgo on February 23, 2014 at 12:37 AM