Finding an ObamaCare doctor is not as easy as advertised

Posted by K R on

If the first two horsemen of the ObamaCare apocalypse were insurance cancellations and rate shock, the third is doc shock: the unpleasant discovery that your heavily subsidized ObamaCare plan doesn’t cover your old doctor, and finding a new one is tough, because some doctors don’t want ObamaCare patients. USA Today had more news on that subject Tuesday:
Now that many people finally have health insurance through the Affordable Care Act exchanges, some are running into a new problem: They can’t find a doctor who will take them as patients. Because these exchange plans often have lower reimbursement rates, some doctors are limiting how many new patients they take with these policies, physician groups and other experts say. “The exchanges have become very much like Medicaid,” says Andrew Kleinman, a plastic surgeon and president of the Medical Society of the State of New York. “Physicians who are in solo practices have to be careful to not take too many patients reimbursed at lower rates or they’re not going to be in business very long.”
There follows what seems like a bit of a dispute over how much ObamaCare plans reimburse doctors:
Kleinman says his members complain rates can be 50% lower than commercial plans. Cigna and Aetna, however, say they pay doctors the same whether the plan is sold on an ACA network or not. United Healthcare spokeswoman Tracey Lempner says it’s up to their physicians whether they want to be in the exchange plan networks, which have “rates that are above Medicaid.” Medicaid rates are typically below those for Medicare, which in turn are generally lower than commercial insurance plans. To prevent discrimination against ACA policyholders, some insurance contracts require doctors to accept their exchange-plan patients along with those on commercial plans unless the doctors’ practices are so full they simply can’t treat any more people. But lower reimbursement rates make some physicians reluctant to sign on to some of these plans or accept too many of the patients once they are in the plans.
I suppose it’s possible Cigna and Aetna have more generous reimbursement policies than other providers, at least in New York, but the rest of the article makes it clear there is a real reluctance among doctors to get involved with these plans. via Human Events.

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