“Substandard” and “cut- rate” is what President Obama calls the health plans that millions of Americans have lost, even though they wanted to keep them. Backpedaling on his promise that “if you like your plan, you can keep your plan,” Obama is now telling Americans another whopper. The president claims the insurance Americans can get on Obamacare exchanges is a better deal.
Don’t believe him. On the exchanges, you may no longer be able to use the doctors and hospitals you prefer. Many exchange plans exclude the top drawer academic hospitals like Cedar Sinai in Los Angeles, the Mayo Clinic in Minnesota and New York Presbyterian in New York City. Instead, the law says that exchange plans must cover care at “essential community providers … that serve predominantly low-income, medically underserved individuals.” (Sec. 1311c(1)C) That means clinics, public hospitals and hospitals largely serving the Medicaid community.
The law’s authors reasoned that exchange plan customers should be able to shift back and forth between their plans and Medicaid, as their earnings fluctuate, without changing doctors and hospitals. That’s reasonable, but it’s bad news for consumers who had access to esteemed hospitals and doctors under their old plans and then got pushed into the exchanges.
Medicaid level care is, sadly, “substandard” to use the president’s word. A review of the experiences of nearly 900,000 patients undergoing eight different surgical procedures found that Medicaid patients were 50 percent more likely to die in the hospital after surgery than patients with private coverage. This review, by researchers at the University of Virginia, is one of several studies proving that Medicaid patients get worse care than patients with private insurance.
But many of the plans being offered on the exchanges are Medicaid with a private label slapped on them. The McKinsey Center for U.S. Health System Reform reports that Medicaid insurers are playing a large role in the exchanges.
Just as many doctors refuse to accept Medicaid, they are also refusing to accept exchange insurance. In California, a Blue Cross plan on the exchange covers 47 percent fewer doctors than Blue Cross subscribers in California currently get.
In New York, only a quarter of physicians have decided to take exchange insurance, because the payments are so low.
Why so low? Because insurers know the low-cost plan will be king in nearly every exchange. All the plans offer the “essential benefit package.” Customers currently have no other way to compare than on price.In New York, only a quarter of physicians have decided to take exchange insurance, because the payments are so low.
That’s despite the law’s promise that exchanges would list each plan’s quality rating and disclose which hospitals and doctors are covered, (Sec. 1311d(4)D) and (Sec. 1311c(1)B). Why isn’t this information provided, as the law requires? We can only guess that it’s because Obamacare administrators don’t want us to see the truth.
Cancer patients whose plans are cancelled are getting whacked the hardest. They are losing access to the specialized cancer hospitals and oncologists treating them. And they will get meager help, if any, paying for innovative cancer drugs that cost thousands of dollars.
The most troubling provision in Obamacare’s Section 1311 gives the Secretary of Health and Human Services blanket authority to control how doctors and hospitals treat patients. This is all in the name of improving “quality.” This could mean everything in medicine.
What that means for you is that if you enroll in an exchange plan, with or without getting a subsidy, your care will be standardized by the federal government with an eye to reducing what you consume and how much it costs. Your doctor may have to choose between doing what’s right for you and avoiding a penalty. Exchange plans can pay only those doctors who obey whatever regulations the secretary imposes.
Yet the president claims that people losing their health plans and having to sign up on the exchanges will be getting a better deal. Losing your doctor, blind shopping for a health plan, and settling for Medicaid-level care and government controls, all for a premium 41 percent higher than before with a deductible that’s doubled that sounds substandard to me.
Right now, most people getting cancellations bought plans in the individual market. Wait until the other shoe drops in 2014 and millions more people who had coverage through their job lose it. The truth about Obamacare will become so painfully obvious that even the White House lie machine won’t be able to cover it up.
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