Nearly 1/4 of doctors may opt out of Obamacare exchanges in 2015

Do you suppose any of the 2014 candidates will find time in the closing week to talk about Obamacare again, in the midst of all the other slow rolling disasters? (Aside from the occasional Root and Branch repeal call, that is.) If they do, they might want to mention a new study from the Medical Group Management Association which has some rather depressing figures in terms of medical services availability next year for participants. Barbara Boland has the story.

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Over 214,000 doctors won’t participate in the new plans under the Affordable Care Act (ACA,) analysis of a new survey by Medical Group Management Association shows. That number of 214,524, estimated by American Action Forum, is through May 2014, but appears to be growing due to plans that force doctors to take on burdensome costs. It’s also about a quarter of the total number of 893,851 active professional physicians reported by the Kaiser Family Foundation.

In January, an estimated 70% of California’s physicians were not participating in Covered California plans.

Once you read the list of reasons for why doctors might not care to participate, these numbers don’t seem surprising at all. (And frankly had been predicted years in advance.) Reimbursement rates under Obamacare average 60 cents on the dollar as compared to private or employer provided coverage plans. The lower rates were supposed to be made up for by the doctors taking in more patients, but many of them are already at max capacity, and some of the new patients are sicker, requiring more time and attention from the physician.

Further, low income patients who took high deductible plans are less likely to actually pay their share. And HHS guidelines require the insurer to cover the patient for 90 days after they stop paying premiums, but leave it up to the doctors to recover the money for the last sixty days of that period.

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None of this provides a lot of incentive for medical providers to take on new patients enrolled under the Affordable Care Act exchanges. And everyone celebrating that great victory for the American consumer might begin feeling a bit differently if they can’t find anyone to see them with their new plans. If that happens, the sick wind up back in the emergency room lines with bills which their government plan will not cover in large amounts. If only someone had warned us…

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David Strom 6:40 PM | April 18, 2024
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