Narrow Networks: ObamaCare promised to expand access to health care. But a couple of reports this week underscore the fact that just having an ObamaCare insurance card doesn’t guarantee access to care.
An inspector general audit of Medicaid found that newly enrolled patients who came into the program through ObamaCare won’t necessarily find a doctor willing to treat them.
For example, the IG reports that a person enrolled in a Medicaid plan in one state would have to drive more than 75 miles to see a urologist.
Enrollees in another state couldn’t make appointments with 45% of the primary care providers listed as participating in one area of the state. (The IG doesn’t identify the states.)
The IG found that while states have “access standards” for managed care plans that contract with them to provide Medicaid benefits, these standards can be vague, and only a handful of states bother to conduct tests to see if the plans are complying.
The federal government checks only whether a state has standards in place, not whether they’re any good.
Thanks to Medicaid’s low payment rates and cumbersome regulations, doctor shortages in Medicaid were already a chronic problem before ObamaCare pushed states to expand the program, which 27 have done so far. A 2012 study found that almost a third of doctors refused to take new Medicaid patients.
ObamaCare just adds to this problem, handing out millions of freshly minted Medicaid cards for a program that can’t handle those already in it.
Worse, ObamaCare is now expanding this deceptive Medicaid model to the private insurance market.
To keep premiums down in the face of ObamaCare’s costly market regulations and mandates, most insurers set up narrow — even extremely narrow — provider networks.
The result is the same as in Medicaid.
Enrollees are promised comprehensive benefits and subsidized premiums, only to find care difficult or impossible to get when they need it.
In California, Anthem Blue Cross has already been sued over its skimpy provider lists. And the Los Angeles Times reported this week that consumers in that state will, if anything, find it harder to see a doctor next 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,” the Times found.
It’s no surprise, then, to learn that ER doctors report a surge in hospital visits from ObamaCare enrollees, often for routine care and often after looking in vain for a doctor to see them.
“We’ve given people an ATM card in a town with no ATMs,” is how Dr. Ryan Stanton of the American College of Emergency Physicians correctly described the situation to USA Today.
Negative word of mouth about such problems might be part of the reason why ObamaCare’s popularity is lower today than when it officially launched a year ago.
Passing out insurance cards is easy. Expanding actual access to health care is hard. (IBD)
Talk is cheap. Especially political motivated agenda talk.