“The bottom line is this law is working and will work into the future,” President Barack Obama said of his signature Affordable Care Act on Tuesday. It would be easier to believe the president if he hadn’t said in 2009, “If you like the plan you have, you can keep it. If you like the doctor you have, you can keep your doctor, too.”
One million Californians who lose their individual plans in 2014 know that’s not true; when many saw their new premiums, they experienced “sticker shock.” Next comes “doc shock” — the revelation that many folks also won’t be able to keep their doctors.
Meet Chico, Calif., attorney Kenneth Turner. His wife found out that she has breast cancer two days before they received their cancellation notice. She’s scheduled for surgery Dec. 20 and will hear the prognosis Dec. 30. Two days later, she loses the doctor who will have operated on her, as well as other doctors she has seen for decades.
Because state Insurance Commissioner Dave Jones used a technicality to force Blue Shield to grant 90-day reprieves, the Turner family will be able to extend its plan — and face two years’ worth of deductibles in 2014. Turner is just glad the family can afford that. “A lot of people couldn’t swing this,” Turner said. “I’m lucky I can.”
California Association of Health Plans President Pat Johnston acknowledged that the state’s 19 regions can restrict access to outside providers. Johnston believes that all consumers will have access to “quality care” but not necessarily the same doctors.
There also will be fewer choices in the new health order. Blue Shield is restricting access to close to half of its doctors and a quarter of its hospitals in the individual market — and Blue Shield spokesman Steve Shivinsky told The Orange County Register these providers “had to agree to cut their rates” to get into the network.
In Southern California, the Los Angeles Times reported, Health Net individual policyholders will have access to less than a third of the doctors on employer plans.
Peter Lee, executive director of Covered California, told the San Francisco Chronicle that all but three of the 12 state exchange providers limit doctors and hospitals.
Lee rightly points out that for years — even before Obamacare — the market has narrowed choices to cut costs. He is absolutely right. The New York Times reports that the University of California, Berkeley is about to exclude two nearby Sutter hospitals because UC could not reach a price agreement with California’s highest net-income nonprofit hospital.
Critics of today’s delivery system rejoice in such moves because they want a single-payer system. But the UC faculty union warned that the move will lead to “significant degradation in the quality of insurance” and “significant increases in costs” for members seeking “the same quality of care.”
When employers cut off providers, the market can respond. When states and the federal government restrict access, they begin to make every health plan into a health maintenance organization.
Johnston believes that most consumers can find a plan with quality local providers. As for those doctors who no longer will be providers in the post-Covered California system, he noted, “Some doctors don’t want to take a lower rate than they used to take.”
Obama should have said: If your doctor likes a pay cut, you can keep your doctor.
Email Debra J. Saunders at email@example.com.