Video: WA “premium” exchange plan not so golden after all
posted at 3:21 pm on March 24, 2014 by Ed Morrissey
Barbara Boxer may argue that ObamaCare has been a huge success and Joe Biden may want to propose Barack Obama for sainthood, but the experience for most Americans has been far from heavenly. Even those who opted for the gold-level plans get unpleasant surprises when attempting to access medical services. In Washington, KOMO reported this weekend that one family paying high premiums for gold-level coverage will now also pay for half of all hospital costs after an emergency sent their daughter to a hospital that exists to treat children:
In early March, her 16-year old daughter had a medical emergency. Alex drove her to the nearest hospital, which was Seattle Children’s. Alex says doctors there felt her daughter’s situation was so dire she needed to be admitted to the hospital immediately. She was there for nine days.
Then came news that her stay, which involved specialized mental health care for adolescents, was going to cost $36,000 and her insurance would only pay for half because Seattle Children’s was considered on out-of-network facility.
She thought by going for the highest premium PPO gold level coverage offered the state exchange, a majority of the bill would have been covered.
“I’m paying a premium for that and I’m willing to pay that premium, but I expect to get services that are not so limited by the insurance companies,” she said.
She’s not alone. Seattle Children’s says its treated more than 125 patients who are not covered by policies offered by the exchange. In October, the hospital filed suit against the Office of the Insurance Commissioner, claiming the state office failed to ensure adequate network coverage in plans from its biggest providers like Premera Blue Cross.
“Because Seattle Children’s was not included in the major plans, children coming for care here were going to be denied care and in fact that’s what we are seeing,” said Dr. Sandy Melzer, senior vice president and chief strategy officer for Seattle Children’s.
Small wonder, then, that the uninsured aren’t exactly impressed with the rollout of ObamaCare:
The Kaiser Foundation has a cool interactive infographic tool to examine the polling they’ve done on the Affordable Care Act since it was passed, four years ago. You can click through the tool to see how approval and disapproval ratings have changed across different demographic categories and over the years. For the most part, opinion hasn’t changed much — it’s ticked up slightly over the last four or five months for most demographic groups, during the law’s troubled rollout, but not by a huge amount (a finding Gallup’s replicated). The one striking finding: Disapproval of the law among the uninsured population has risen substantially over the past few months …
Assuming the finding holds up, why might it be happening? For one, they’re more likely to be interacting with the law: Navigators are trying to reach them; some of them have probably been on the individual market at times, which only a limited percentage of Americans are, and are now seeing themselves priced out of coverage; others are perhaps just disappointed with what the law has to offer, or that its plans aren’t free, period. Some of them could be people who would have been eligible for Medicaid if their state had expanded it, and now see people making a little more money getting heavily subsidized insurance while they’re left out in the cold. It’ll be interesting to see if this trend holds up.
As the insured attempt to get medical care and find out just how little their coverage means, those trends won’t be limited to just that demographic.