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Nov 13 2013

Doctors Don’t Want ObamaCare Either

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The ObamaCare saga of working to produce better care, more options, and lower prices continues – miserably. I’ve already discussed the impacts of ObamaCare on a broad scale and how similar programs in Massachusetts has caused the entire industry to start sinking. But what are the doctors, nurses, and hospitals saying about Obama’s healthcare reform?

It turns out that over 50% of physicians are saying “no”. In fact, a recent survey conducted by Medical Group Management Association found that only 29% of doctors had decided to sign on – and most of them are doing so due to prior contractual obligations or hospital affiliations, which leave them no choice in the matter. A survey conducted by the New York State Medical Society found similar results and likened the ACA to “a plague.” Participants in both surveys cited high regulatory and financial burdens that would force them to ration care and, potentially, go out of business. Some doctors also claimed that in preparation for total implementation, insurance companies have already been denying patients’ access to medications and referrals.

Of particular concerns to a large number of providers is a special loophole in the ACA called Section 156.270 that requires insurers to provide a 90-day grace period of continued coverage to customers who cannot pay their premiums – after which time they can choose to jump ship, grab another plan, and continue a new grace period with no penalty. If the patient does not pay their premiums, the only thing that happens is that the insurance company stops paying, too – and providers get left with the bill. And, just like everything else in life, nothing is free – if a patient cannot pay during the second and third months of their grace period, the providers are held liable for the bill themselves. If a provider mistakenly gets paid by insurance companies during that grace period, the money must be returned, and if no one has paid the bill by the end of the grace period, it disappears of insurance companies’ books. The trade organization America’s Health Insurance Plans’ write-up, Summary of Final Rule on Establishment of Exchanges and Standards for Qualified Health Plans, comes to the same conclusions. The Advisory Board – a healthcare research firm – actually advises small practices to refuse ObamaCare exchange plans, or else go broke.

But say a practice ignores these recommendations or concerns, and decides to take ACA exchange plans after all. If contending with the possibility of financial loss and liability during the grace period, practices are also facing low reimbursement rates tied directly to Medicare and Medicaid – which have the lowest reimbursement rates. In fact, ACA plans have reimbursement rates 70% below those of traditional insurances. As noted in my previous articles on ObamaCare, this means more patients crammed into smaller amounts of time to help make ends meet, and will likely breed some cranky physicians. Regardless of whether or not you believe doctors are overpaid, no one wants a 70% pay cut.

So if over 50% of medical providers aren’t taking any of the ObamaCare health plans, and most of the nations top hospitals aren’t buying in either, it seems safe to say that the ACA has not expanded the pool of available doctors and care as the Obama administration stated it would when everyone got insurance. In fact, due to the amount of providers not taking the insurance, many patients could see delays in receiving care due to the fact that there just won’t be enough doctors to go around. Patients will find themselves having to attend emergency rooms or walk-in clinics where they do not have their own personal physician and, as a result, might receive less attention and inferior care. Add on top of it the practices that might go out of business due to administrative and financial burdens, and the picture is very grim indeed. If ObamaCare isn’t lowering prices, getting people better care, or increasing availability of care, what is it doing?

1 comment

  1. Jeffrey Hunt

    I have to disagree with you. From a research paper 3 years ago discussing how hospitals are closing emergency rooms and urgent care centers are closing, EMTALA law provided desperately needed care for people who were arriving at hospitals, near death, but were turned away for no insurance. Unfortunately the 1996 EMTALA law did not provide funding. Many hospitals who originally took federal low-cost or no-cost loans provided by the Hill-Burton Act never provided the indigent care they were required to provide, despite accepting these monies. So with a health care system, so out of whack, the government had to reign these hospitals in to provide the little care they had promised: We got Romney, or Obama-care, or better yet, the Affordable Care Act. Unless you have worked as many years in an ER as I have, or know of someone who has, you have seen why we needed something to be done, because everyone ended up paying for people who waited until the last minute for an ER visit- people just didn’t have money for health care. Many physicians and papers were written, in published journals, asking for some sort of fix so that people would go to primary care physicians, be treated well, at a much lower cost than an ER or an Urgent Care. The ACA has many issues, but they can be fixed. We can’t go on pretending there isn’t a problem with the ordinary person, who makes just enough to feed their family, but not enough to pay for health care- not everyone is going to make more than $30K a year- someone has to push a broom, but they still need healthcare.

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