From John R. Graham:
Thank providence for USA Today, which has given us yet another story describing how poor access to health care is under Obamacare.
People who fell for navigators’ sales pitches and signed up for Obamacare are discovering that it is junk insurance:
“The exchanges have become very much like Medicaid,” says Andrew Kleinman, a plastic surgeon and president of the Medical Society of the State of New York. “Physicians who are in solo practices have to be careful to not take too many patients reimbursed at lower rates or they’re not going to be in business very long.”
Kleinman says his members complain rates can be 50% lower than commercial plans.
“I definitely feel like a bad person who is leeching off the system when I call the doctors’ offices,” she says. Shawn Smith of Seymour, Ind., spent about five months trying to find a primary care doctor on the network who would take her with a new, subsidized silver-level ACA insurance plan.
Note: This person had a silver plan, not a bargain basement bronze plan.
More: Government Buries Evidence of Poor Access to Care under Obamacare | Health Policy Blog | NCPA.org.
From David Hogberg at the National Center for Public Policy Research:
When millions of people in the individual health insurance market lost their health plans in late 2013, ObamaCare supporters claimed those lost plans were “substandard” or “crappy.” However, they failed to support that contention.
This study examines the claim that the policies on the individual market were inferior in quality to those on the ObamaCare exchanges. First, it compares the premiums and the size of the deductibles as well as maximum out-of-pocket costs of policies on the individual market prior to the exchanges to those of current polices on the exchanges. Second, it examines the quality of provider networks by comparing the number of plans that are HMOs versus those that are PPOs in the individual market prior to the exchanges and those now on the exchanges.
The study finds that there were many policies on the individual market that had lower premiums and lower or equal deductibles and out-of-pocket maximums than the cheapest plans now available on the exchanges. It also finds that the individual market prior to the exchanges offered a greater choice of hospitals and physicians since it contained far more PPO policies than HMO policies, whereas the exchanges offer more HMO policies.
Read the whole study: Despite ObamaCare Supporters’ Claims, Health Insurance Plans Prior to ObamaCare Exchanges Were Neither ‘Crappy’ Nor ‘Substandard’.
Via the National Center for Policy Analysis.
From the Associated Press:
[M]ore consumers realize they bought plans with limited doctor and hospital networks, some after websites that mistakenly said their doctors were included.
Before the law took effect, experts warned that narrow networks could impact patient’s access to care, especially in cheaper plans. But with insurance cards now in hand, consumers are finding their access limited across all price ranges.
The dilemma undercuts President Obama’s 2009 pledge that: “If you like your doctor, you will be able to keep your doctor, period.”
More: Consumers losing doctors with new insurance plans – The Washington Post.
Via the NCPA.
In the Wall Street Journal, John Goodman explains why “The Government Is the Worst Vendor Possible for Managing Health-Insurance Exchanges.” Excerpts:
One problem is that too little money was budgeted for creating the exchanges, which are the online markets where people can choose among competing health plans and prices. …
A second problem is complexity. The Obama administration wants something the federal government has never done: a computer system that connects HHS, the Internal Revenue Service, the Social Security Administration, Homeland Security and perhaps other departments. This is a herculean task with unclear benefits. …
A third and much bigger problem is competency. … In July 2011, Fortune magazine reported that the government is spending $80 billion a year on buying and operating information technology, and much of it is simply wasted. …
One of the worst mistakes the federal government makes is the tendency to try to reinvent systems the private sector has already invented. The government has been true to form under the health-reform law, completely ignoring private exchanges that are up and running.
John Goodman: Navigating the ObamaCare Maze – WSJ.com.
Health Policy Solutions Reports:
As Colorado’s health exchange managers sprint toward an October 1 launch, a top manager warned board members on Monday that a recent decision to build a new “eligibility” IT system poses the greatest risk of delay and could undermine the quality of the online health marketplace.
Adele Work, who is leading implementation for the exchange, made a presentation about “key implementation risks” during a technology update for the board.
More: ‘Risks’ loom for health exchange technology | Health Policy Solutions.
At Forbes, Scott Gottlieb, MD provides a warning for Coloradans who will to buy health coverage through the Colorado Health Benefits Exchange (“Connect for Care Colorado”):
There’s an astute article in today’s edition of the Wall Street Journal by veteran healthcare reporter Anna Mathews. It outlines the scope of health plans that will be offered on the new exchanges taking shape this fall. And why Obamacare is looking more and more like Medicaid.
Mathews notes that hospitals are giving up discounts to the new exchange-based health plans. In turn, the hospitals plan to make up these discounts through the narrow networks of providers that consumers will be able to choose from. The bet that these hospitals are making is that they can offset the discounts by getting more volume. …
[Wi]th fewer out-of-pocket costs, consumers will also have far less skin in the game. In turn, they will have less incentive to constrain their demand for services.
That constraint will instead be applied by the providers themselves, through the limitations that they place on access. Not by outright denying care, but by funneling patients into overworked networks that make it much harder to actually get appointments and schedule needed services. This is exactly how rising demand is managed under Medicaid. It’s one more reason why Obamacare coverage is likely to resemble Medicaid over time.
More: The New Obamacare Insurance Is Looking More Like Medicaid – Forbes.
See also: Survey: Medicaid-Level Rates Could Cripple Health Insurance Exchanges.
Health Policy Solutions reports:
Colorado’s health exchange is supposed to debut in just six months, but having the technology ready by Oct. 1 may be an impossible task.
Critical problems threaten the system, ranging from a lack of coordination with the state’s technology office and historic problems with state IT systems to poor oversight by exchange managers and contractors and the potential for serious conflicts of interest among those charged with creating the complex multi-million dollar exchange system.
More: Tech troubles could hobble health exchange | Health Policy Solutions.
See also Avik Roy at Forbes: “CMS on Obamacare’s Health Insurance Exchanges: ‘Let’s Just Make Sure It’s Not a Third-World Experience‘”