Not so easy to cash in on your ObamaCare plan
by Chris Woodward
May 18, 2016
Source One News Now
Health insurance enrollees are finding not every provider accepts ObamaCare plans. It's a more common problem than is thought.
According to information first published in The New York Times, some people who enrolled in a New York exchange plan haven't had an easy time locating a doctor or hospital that accepts their insurance. Still, Devon Herrick, Ph.D. at the National Center for Policy Analysis says this is a widespread problem beyond just New York.
"It's really a two-faceted issue," he begins. "First off, you have providers who say, We don't want those low rates, we're not willing to accept the low, paltry rates some of these plans pay. It's also some of the health plans themselves - that is, the insurers trying to create these health plans."
According to Herrick, some insurers are looking for and creating narrow networks.
"They create a smaller network with fewer doctors, and the idea is to give these doctors more business in return for a reduced rate,” he explains. “But what it means for the enrollee is, Hey, my doctor is probably not in that network, and I have to find somebody who is."
While the practice is legal, Herrick argues it's used as a way to deliberately keep some patients out of a plan.
Herrick, Devon (NCPA)"There are some limitations," he continues. "They're required to have adequate networks, but who knows what that means? This is, I think in some cases, a deliberate attempt to try to prevent or maybe inhibit or discourage some of the sicker patients or sicker enrollees from joining their plan."
OneNewsNow asked Herrick if this is all the more reason for political candidates to be more vocal about healthcare, its problems and any solutions they envision.
"Our health system was broken in the first place and ObamaCare only made that worse,” he responds. “But the knee-jerk reaction to the new regulations and requirements for health plans is simply to try to force companies to take patients or enrollees who are unprofitable."