Another Obamacare Promise Broken: WSJ: "Many Health Insurers To Limit Choices Of Doctors, Hospitals"

A new poll of American voters shows a majority — 57 percent—support defunding this unfair, unaffordable, unworkable law. ~ Heritage Action for America and Basswood Research

Another week, another news story showing that Obamacare will break an explicit promise made by President Obama and Democrats in Congress as they attempted to sell it to a skeptical public. In June 2009, in a speech to the American Medical Association, President Obama said, “So let me begin by saying this to you and to the American people: I know that there are millions of Americans who are content with their health care coverage -- they like their plan and, most importantly, they value their relationship with their doctor. They trust you. And that means that no matter how we reform health care, we will keep this promise to the American people: If you like your doctor, you will be able to keep your doctor, period.”

Today, in an article titled, “Many Health Insurers to Limit Choices of Doctors, Hospitals,” The Wall Street Journal reports, “This fall, Indiana's new online health-insurance marketplace will present some tough choices for consumers like John Nowak, who will be able to pick a plan from his current insurer—or go for one that includes his primary-care doctor. That is because Mr. Nowak's current insurer won't include Indiana's biggest health-care provider, 19-hospital Indiana University Health, in the plans it sells on the consumer exchange. If Mr. Nowak buys a new exchange plan from WellPoint Inc.'s Anthem Blue Cross and Blue Shield, he will generally have to pay the cost out of his own pocket if he sees the system's doctors, because they aren't in the network. Mr. Nowak, a 48-year-old Indianapolis medical-spa owner, likes WellPoint. But he has been seeing an Indiana University-affiliated physician for five years, and ‘when you get a trust with a doctor, you want to stick with them,’ he said. Similar situations are likely to occur around the country, as details emerge about the coverage available through the new consumer marketplaces created by the federal health law. Many of the plans will include relatively few choices of doctors and hospitals. In some cases, plans will layer on other limits, such as requirements that patients get referrals to see specialists, or obtain insurer authorization before pricey procedures. A McKinsey & Co. analysis of 955 consumer exchange-plan filings, from 13 states that were among the earliest to make them public, found that 47% were health-maintenance organizations or similarly designed plans. Such plans generally don't pay for care provided outside their networks. A number of other plans, though classed as preferred-provider organizations, or PPOs, will also have limited choices of doctors and hospitals in their networks. The big reason behind these limited plans: Cost. . . . Smaller networks of providers generally translate to lower premiums, because insurers can negotiate discounts with health-care providers who will then have less competition for patients within the network. WellPoint said it is using more-limited networks for most of the new marketplaces, and it aims to take at least 10% out of the premium costs.”

And while Americans using Obamacare’s new exchanges will be facing higher premiums and limited choices (violating Obama’s promises), CNBC reports that they’ll be at risk for another serious problem. “As the debate rages over who benefits from the Affordable Care Act, one thing is becoming clear: The controversial program is a dream come true for rip-off artists. Consumer experts warn that the program has created a huge opportunity for swindling people by stealing their money and their sensitive personal information. . . . Scammers have been at it for more than a year now, but consumer advocates and security experts warn that the problem will worsen as we get closer to Oct. 1. That's when the millions of uninsured Americans can use a health insurance exchange, set-up by their state or by the federal government, to shop for coverage. ‘I believe the incidents are going to skyrocket as that date approaches,’ said Eva Velasquez, president and CEO of the nonprofit Identity Theft Resource Center. ‘And even people who are smart and savvy could get taken, so we are very concerned about the potential for some serious financial harm.’ . . . ‘There are fake exchanges already up and running on the Internet,’ said Monica Lindeen, Montana's Commissioner of Securities and Insurance. ‘If you do a search and type in “exchange,” you'll find all sorts of websites that claim to be in the exchange when they are not.’ . . . Scam artists got an early jump on national health care reform. Since last year, they've been calling, faxing and emailing people across the country claiming to be with Medicare, Obamacare or some agency of the federal government. They often say they need to ‘verify’ some personal information (typically a bank account or Social Security number) to ensure you get the proper benefits. In some cases, fraudsters tell victims they need to buy an insurance card to be eligible for coverage under the new program. . . . A con artist can claim to be anyone, for instance a ‘navigator’ who can help you apply for coverage through an exchange. They gain your trust and then ask for personal information to buy nonexistent policies. Fraud.org reports that some victims have been persuaded to wire money or send funds via prepaid debit card to get their full benefits.

The Los Angeles Times wrote last month, “The national health reform law is expected to open the door for identity theft and insurance scams when millions of uninsured Americans begin enrolling in coverage this fall, officials and advocates warn. The Federal Trade Commission said dozens of consumers have reported fraud since last summer's Supreme Court ruling upholding the law, and officials predict widespread abuse when enrollment begins in October.” And McClatchy added, “Fraudsters are poised to take advantage of widespread confusion over the Affordable Care Act -- also known as Obamacare -- to steal Americans' credit cards, Social Security numbers and other personal information, consumer advocates and government officials say. ‘This is the huge, new government program. There's no doubt in my mind that the fraudsters view it as an opportunity to rip people off,’ said Lois Greisman, associate director for the Federal Trade Commission's division of marketing practices. The FTC already has issued a consumer alert about one telemarketing scheme, in which impostors claiming to be from Medicare told consumers they needed to hand over their personal or financial information in order to continue eligibility because ‘change is on the horizon.’”

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