LA Times: 'Obamacare Doctor Networks Stay Limited In 2015' | Obamacare Open Erollment Begins

Editorial Cartoon by AF "Tony" Branco

ARRA News - Over the weekend, the Los Angeles Times reported, “Finding a doctor who takes Obamacare coverage could be just as frustrating for Californians in 2015 as the health-law expansion enters its second year. The state's largest health insurers are sticking with their often-criticized narrow networks of doctors, and in some cases they are cutting the number of physicians even more, according to a Times analysis of company data. And the state's insurance exchange, Covered California, still has no comprehensive directory to help consumers match doctors with health plans. This comes as insurers prepare to enroll hundreds of thousands of new patients this fall and get 1.2 million Californians to renew their policies under the Affordable Care Act. Even as California's enrollment grows, many patients continue to complain about being offered fewer choices of doctors and having no easy way to find the ones that are available. Some consumers have been saddled with huge medical bills after insurers refused to pay for care deemed out of network.”

According to the Times, “Altogether, the 10 insurers in Covered California have contracted with an estimated 75% of California's licensed physicians, or nearly 90% of those considered active in the state. However, many of those doctors are available in just one or two health plans.”

Meanwhile, some insurance companies are dropping even more doctors and hospitals from their networks. “Health Net has proposed the most dramatic change for 2015, the data show. It's dumping [its PPO network] and switching to a plan with 54% fewer doctors and no out-of-network coverage, state data show. Yet premiums for that stripped-down policy are going up as much as 9% compared with pricing for the PPO. . . . Health Net said its cutbacks were necessary to avoid even steeper rate hikes and it's confident the smaller network will be sufficient. . . . The insurer is following the lead of its two rivals Anthem and Blue Shield, which opened last year with sharply limited networks. For 2015, Blue Shield has proposed two health plans with up to 4% fewer physicians in the areas where they're sold.”

As Republicans warned when Obamacare was passed, these outcomes were inevitable from the regulations that the unpopular law put in place.

The report notes that the California Obamacare exchange is actually pleased with this practice. “Covered California endorses the industry's narrow network strategy as a way to keep premiums affordable. The state has credited it for helping produce two straight years of lower-than-expected premiums for individual coverage. . . . In addition to shedding doctors, California's biggest insurers have promoted more restrictive policies known as EPO, or exclusive-provider organization, plans. Unlike a more generous PPO, an EPO typically does not provide any coverage for out-of-network providers. Consumers would be responsible for the full charges if they left their network. Many consumers say those differences in coverage weren't disclosed fully.”

Meanwhile, the LA Times points out that “[t]here's no timetable for a state provider directory after the exchange scrapped an initial version that was riddled with errors. Instead, Covered California refers people to insurance company websites that vary in usefulness.”

But, with the provider directory still nonexistent, The Wall Street Journal reports that Covered California is making sure it’s spending a large sum on advertising. “To get new enrollees, the California exchange, Covered California, in September launched ads featuring residents talking about how coverage under the health law has benefited them, part of a $46 million statewide advertising campaign.”

Narrow networks and endless bureaucratic snafus that frustrate and confuse consumers: just more of the predictable consequences of President Obama and Washington Democrats deciding to try to have government regulate 1/6^th of the American economy.

Also. with Obamacare open enrollment set to begin this week, more horror stories about the president’s healthcare law continue to emerge. The Government Accountability Office (GAO) released a report highlighting the administration’s spending to implement the online exchanges. The GAO found that, due to an outdated record-keeping system, the Centers for Medicare & Medicaid Services (CMS) was unable to track spending for the exchanges. In addition, Forbes contributor Chris Conover reported the average family of four will see an increase of $7,450 in health spending over the next decade. Read on for the top stories for the week:

$3.7 Billion Spent To Implement The Obamacare Exchanges In 2014. The Government Accountability Office (GAO) released a report last week, noting the administration needs to improve the oversight of finances used in the implementation of Obamacare. According to the report, the “GAO was able to determine the reliability of CMS’s estimates for total obligations for fiscal year 2014, which was $3.7 billion.” In addition, the only other CSM information that could be verified was $79.8 million spent on staff salaries. GAO noted, “the number of staff as of September 30, 2013, which was 347; and total salary expenditures from March 2010 through fiscal year 2013, which were $79.8 million.”

Between 2014-2022, Obamacare Will Add $7,450 To The Average Amount Of Health Spending For A Family Of Four. As reported by Forbes contributor Chris Conover, “Between 2014 and 2022, the increase in national health spending (which the Medicare actuaries specifically attribute to the law) amounts to $7,450 per family of 4.” Jim Capretta at the American Enterprise Institute (AEI) noted, “An important takeaway from these new projections is that the CMS Office of the Actuary finds no evidence to link the 2010 health care law to the recent slowdown in health care cost escalation.” More signs point to a historical trend in health spending than Obamacare.

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