WaPo: Sorry, But a lot of People Won't Be Able to Keep Their Doctors Either

Posted: Nov 21, 2013 4:35 PM

Senate Democrats' historic power-grab may have consumed the Beltway news cycle today, but out in the real world, the Obamacare reckoning continues. The Washington Post addresses the "access shock" issue that millions of Americans will begin confronting in 2014, with millions more waiting in the wings.

As Americans have begun shopping for health plans on the insurance exchanges, they are discovering that insurers are restricting their choice of doctors and hospitals in order to keep costs low, and that many of the plans exclude top-rated hospitals. The Obama administration made it a priority to keep down the cost of insurance on the exchanges, the online marketplaces that are central to the Affordable Care Act. But one way that insurers have been able to offer lower rates is by creating networks that are far smaller than what most Americans are accustomed to. The decisions have provoked a backlash...The result, some argue, is a two-tiered system of health care: Many of the people who buy health plans on the exchanges have fewer hospitals and doctors to choose from than those with coverage through their employers. A number of the nation’s top hospitals — including the Mayo Clinic in Minnesota, Cedars-Sinai in Los Angeles, and children’s hospitals in Seattle, Houston and St. Louis — are cut out of most plans sold on the exchange.

The Obamacare exchanges don't include a function that allows consumers to check whether their doctors and hospitals of choice are covered under their new plans, so many of the unpleasant dropped-doctor discoveries will happen on the fly. What do you mean I can't keep my doctor? I need her. Now. The harsh reality is that many doctors are taking a looking at their new, significantly lower reimbursement rates under Obamacare, and are heading for the exits. As mentioned above, this trend is fueling concerns that the president's healthcare law is creating a new underclass of Americans. These people may be "insured," but in many cases, their options for care will be severely limited -- an outcome that the White House might describe as "junk" or "substandard" coverage. As for the White House's "priority" of keeping rates low, how's that going?

Many Americans browsing the Obamacare exchanges are finding the Affordable Care Act isn't living up to its name. It's not just premiums that are bringing up the costs. Consumers are finding high deductibles, co-payments and other expenses that make the Obamacare policies seem more like catastrophic plans than comprehensive insurance. Those picking a bronze plan, which carry the lowest monthly rates, may have to spend $5,000 or more before the insurance kicks in. The next highest level of coverage, the silver tier, can carry $2,000 deductibles. And once they hit their deductibles, policy holders still have to pay for doctor visits, lab tests and medication. "All we ever heard about Obamacare is that it would lower our deductibles and premiums," said Jennifer Slafter, 40 of Mabel, Minn. "That's just not what's happened." Slafter and her husband, Steve, are scrambling to find affordable care for themselves and their two children. The exchange's Blue Cross Blue Shield plan was $1,087 a month with a $6,000 deductible, while a Medica plan was $877 a month with a $12,700 deductible. Both are steeper than their current plan. "Everything got higher," said Slafter, who is still waiting to hear whether they qualify for a premium subsidy. But even if they do, she said she'd still find it very tough to meet the deductibles.

These stories are ubiquitous. Here's one Florida family whose previous plan ($408 monthly premiums, $5,000 deductible) has been dropped and replaced with coverage that costs $671 per month in premiums with an eye-popping $12,500 deductible:

I'll leave you with a genuinely heartbreaking op/ed in today's Wall Street Journal. The personal travails of Edie Sundby are so upsetting because she was lied to, and now her life-saving cancer treatments are in jeopardy. The story of single mother Jessica Sanford is infuriating because she was given false hope and quoted by the president before the mirage of affordable coverage came crashing down. But the experience of Washington State resident Charlene Hopkins represents a different variety of human tragedy. Obamacare has robbed this self-sufficient, conscientious woman of her dignity by effectively forcing her to enroll in a state-run Medicaid program:

Since she couldn't afford the new plan offered by her insurer, she told me she was eager to explore her new choices under the Affordable Care Act. Washington Healthplanfinder is one of the better health-exchange sites, and she was actually able to log on. She entered her personal and financial data. With efficiency uncommon to the ObamaCare process, the site quickly presented her with a health-care option. That is not a typo: There was just one option—at the very affordable monthly rate of zero. The exchange had determined that my mother was not eligible to choose to pay for a plan, and so she was slated immediately for Medicaid. She couldn't believe it was true and held off completing the application. "How has it come to this?" she asked in one of our several talks over the past few weeks about what was happening. When she was a working mother and I was young, she easily carried health insurance for our whole family. "How have I fallen this far?"

Leftists cannot understand how this is bad news. Hey, she's getting free insurance! She should stop whining. This attitude clearly ignores the empirical failure of Medicaid and the terrible coverage it offers (this applies to other programs as well), and it fails to grasp how being shoved onto the dole is a scarring and humiliating experience for many people. Read the whole piece. It's deeply sad, but it should remind conservatives why the struggle against statism is worth the frustration and effort.

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