Obamacare Still Hurting Americans | Has Insurance But Can’t Find A Doctor | Limited Choices For Doctors And Hospitals
Today in Washington, D.C. - July 22, 2014The House reconvened at Noon. Bills anticipated to be considered today:
H.R. 1022 — "To develop an energy critical elements program, to amend the National Materials and Minerals Policy, Research and Development Act of 1980, and for other purposes."
H.R. 3716 — "To ratify a water settlement agreement affecting the Pyramid Lake Paiute Tribe, and for other purposes."
H.R. 4508 — "To amend the East Bench Irrigation District Water Contract Extension Act to permit the Secretary of the Interior to extend the contract for certain water services."
H.R. 4562 — "To authorize early repayment of obligations to the Bureau of Reclamation within the Northport Irrigation District in the State of Nebraska."
H.R. 4572 — "To amend the Communications Act of 1934 to extend expiring provisions relating to the retransmission of signals of television broadcast stations, and for other purposes."
H.R. 4803 — "To require the Transportation Security Administration to conform to existing Federal law and regulations regarding criminal investigator positions, and for other purposes."
H.R. 4812 — "To amend title 49, United States Code, to require the Administrator of the Transportation Security Administration to establish a process for providing expedited and dignified passenger screening services for veterans traveling to visit war memorials built and dedicated to honor their service, and for other purposes."
H.R. 5035 — "To reauthorize the National Institute of Standards and Technology, and for other purposes."
H.R. 5120 — "To improve management of the National Laboratories, enhance technology commercialization, facilitate public-private partnerships, and for other purposes."
The Senate reconvened at 10 AM today. Following 45 minutes, of morning business, the Senate then voted on cloture on 3 district judge nominees for California, Florida, and Louisiana. Yet again, Democrats used their nuclear option to break Senate rules an allow cloture votes on nominees to succeed with fewer than 60 votes. All three of today’s nominations did so.
At 2:15 PM, senators will vote on confirmation of the 3 district court nominees considered this morning.
Yesterday, the Senate voted 94-0 to confirm Julie Carnes to be United States Circuit Judge for the Eleventh Circuit.
A three-judge panel for the U.S. Court of Appeals in Washington ruled (2-1) that subsidies may not be offered in the federal health exchange. The decision overturned a lower court ruling. Hours later. the Fourth Circuit Court of Appeals upheld (3-0) the Obama administration's arguments that subsidies can be applied in the federal exchange. As a result these cases will be appealed and heard by the Supreme Court.
The Tampa Bay Times wrote yesterday, “Charlene Lake thought she got a decent deal through the Affordable Care Act marketplace: a Humana HMO that included a family doctor a few miles from her home. Five months later, Lake wonders if she can even use the insurance she bought. Her plan's dominant health care provider, JSA Medical Group, recently announced that it would take no new patients covered by Humana's exchange HMOs at least until fall. That leaves Lake no choice but to use the community health centers left in her plan's network, rather than the traditional physician's practice on which she planned. . . . [T]he case also shows the downside of limiting consumer choice of physicians through what is known as narrow networks. Or, in Lake's case, a network so narrow it barely exists. ‘You can't make people sign up for a health care plan and then not have a doctor,’ said Lake, a St. Petersburg antiques dealer who is in her 50s. . . . [F]or now, Lake, the St. Petersburg resident, is stuck. She wonders why she's even considered a new patient since she saw a JSA doctor in May. When she called his office recently, the staff told her it was JSA's decision to drop her, not the doctor's. She tried four times one day last week to reach a health center in her network on the campus of Bayfront Health St. Petersburg. No one answered the phone. ‘This is a complete mess,’ she said. ‘They took away my doctor who I had gotten in to see within a few days because they claimed the patient load was too much and replaced him with an office that doesn't even answer their phone.’ Other Humana exchange customers say they've noticed cancellations by JSA physicians. James Trizis, a 52-year-old Clearwater diner owner, said JSA recently rescheduled a September checkup for April. Trizis, who has a heart condition, said he worries that preventative care — a key part of the ACA — will get short shrift. ‘My primary care for me and my family is going to be the emergency room,’ he said.”
The Times noted, “Nationwide, about 70 percent of the lowest-priced plans sold on the exchanges are considered to have narrow networks, according to a study by industry consultant McKinsey & Co. And they've caused problems. In California, for instance, insurance giant Anthem Blue Cross faces multiple consumer lawsuits over its use of narrow networks, with some policyholders saying the company had misled people with inaccurate provider lists. Humana isn't the only Florida provider with network issues; Florida Blue consumers in South Florida told the Miami Herald they had problems getting doctors listed in their directories to accept their plans. . . . In the Tampa Bay area, Humana put most of its primary care business into the hands of JSA, a major physicians group that has long handled the insurer's Medicare Advantage customers. JSA has nearly 165 affiliated and employed physicians in the region. . . . Humana's online directory appears to offer plenty of choices. Last week, HMO customers in St. Petersburg had their choice of around 120 primary-care doctors within a 15-mile radius of downtown. But nearly all of those listings are JSA doctors . . . . JSA, which is owned by Denver health giant DaVita, confirmed it will not see new Humana HMO patients at least until fall. JSA president Lorie Glisson said it had served almost twice as many Humana exchange patients as it had expected in the Tampa Bay area.”
Politico also examines the problem of narrow networks incentivized by Obamacare in a piece today. “Anger over limited choice of doctors and hospitals in Obamacare plans is prompting some states to require broader networks — and boiling up as yet another election year headache for the health law. . . . It’s not just a political problem. It’s a policy conundrum. Narrow networks help contain health care costs. If state or federal regulators — or politicians — force insurers to expand the range of providers, premiums could spike. And that could create a whole new wave of political and affordability problems that can shape perceptions of Obamacare. . . . Obamacare didn’t create the trend, but it did highlight it, as insurers sought to make premiums as attractive as possible in the new market. About 70 percent of the lowest-cost exchange plans were built on narrow networks this year, according to the consulting firm McKinsey . . . . In New Hampshire, for instance, Anthem Blue Cross and Blue Shield was the only insurer on the market, and it cut 10 of the state’s 26 hospitals out of its network. That left residents in some rural areas with long commutes to the nearest hospital in their network, and the issue has become a political football in the congressional races there. . . . Incomplete or inaccurate provider directories were rampant in this year’s plans on both the federal and state exchanges, leading consumers to buy plans thinking they cover their doctors only to find out later they do not. . . . Another complication: Even if a patient goes to an in-network hospital, not all the doctors are necessarily part of the plan. For instance, patients can get stuck with thousands of dollars in bills for anesthesia, even if surgery is covered. ‘What we’re seeing is consumers not knowing and getting stuck with high out-of-network bills,’ said Stephanie Mohl, government relations manager at the American Heart Association.”
As Senate GOP Leader Mitch McConnell said last week, “Obamacare has caused countless women to lose the health care plans they had and liked. When these women first spoke out about the betrayal they felt when they lost their plans, many of the law’s supporters waved their concerns away. They said they were lying, or that their plans were ‘junk’ because, of course, they knew better. It’s a pattern that seems to have continued ever since. American women also now have fewer choices of doctors and hospitals under Obamacare. The bill’s supporters have continually waved those concerns aside too. . . . We kept warning [Democrats] that Obamacare would hurt jobs and increase costs. They had to know that Obamacare was going to reduce choices for women and limit their access to certain doctors and hospitals. But Washington Democrats voted for Obamacare anyway. They created these problems. And that’s why they should be working with Republicans now to start over with real, patient-centered reform that lowers costs and that women and men in this country actually want. But they refuse. They’re just doubling down on Obamacare.”
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