Excerpted from U.S. News & World Report:
The Obama Administration has been claiming that insurance companies will be competing for your dollars under the Affordable Care Act, but apparently they haven’t surveyed the nation’s top hospitals.
Americans who sign up for Obamacare will be getting a big surprise if they expect to access premium health care that may have been previously covered under their personal policies. Most of the top hospitals will accept insurance from just one or two companies operating under Obamacare.
“This doesn’t surprise me,” said Gail Wilensky, Medicare advisor for the second Bush Administration and senior fellow for Project HOPE. “There has been an incredible amount of focus on the premium cost and subsidy, and precious little focus on what you get for your money.”
Regulations driven by the Obama White House have indeed made insurance more affordable – if, like Health and Human Services Secretary Kathleen Sebelius, you’re looking only at price. But responding to Obamacare caps on premiums, many insurers will, in turn, simply offer top-tier doctors and hospitals far less cash for services rendered.
Watchdog.org looked at the top 18 hospitals nationwide as ranked by U.S. News and World Report for 2013-2014. We contacted each hospital to determine their contracts and talked to several insurance companies, as well.
The result of our investigation: Many top hospitals are simply opting out of Obamacare.
Chances are the individual plan you purchased outside Obamacare would allow you to go to these facilities. For example, fourth-ranked Cleveland Clinic accepts dozens of insurance plans if you buy one on your own. But go through Obamacare and you have just one choice: Medical Mutual of Ohio.
And that’s not because their exchanges don’t offer options. Both Ohio and California have a dozen insurance companies on their exchanges, yet two of the states’ premier hospitals – Cleveland Clinic and Cedars-Sinai Medical Center – have only one company in their respective networks.
A few, like No. 1-rated Johns Hopkins in Maryland, are mandated under state law to accept all insurance companies. Other than that, the hospital with the largest number of insurance companies is University Hospitals Case Medical Center in Cleveland with just four. Fully 11 of the 18 hospitals had just one or two carriers.
“Many companies have selectively entered the exchanges because they are concerned that (the exchanges) will be dominated by risky, high-using populations who wanted insurance (before Obamacare) and couldn’t afford it,” said Wilsensky, who is also on the board of directors of UnitedHealth. “They are pressed to narrow their networks to stay within the premiums.”
Consumers, too, will struggle with the new system. Many exchanges don’t even list the insurance companies on their web sites. Some that do, like California, don’t provide names of doctors or hospitals.
Comments
Obamacare might be signing up millions of people who never had insurance before but it is going to be difficult in some places for them to find a doctor to treat them.
Evan Vucci, File / AP Photo
FILE – In this Oct. 21, 2013 file photo, Health and Human Services Secretary Kathleen Sebelius arrives in the Rose Garden of the White House in Washington for and event with President Barack Obama on the initial rollout of the health care overhaul. As the public face of President Barack Obama’s signature health care program, Sebelius has become the target for attacks over its botched rollout. Republicans want her to resign and even some Democrats _ while not mentioning her name _ say someone needs to be fired.
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October 31, 2013
Another Obamacare shoe drops: Docs not participating
Rick Moran
Obamacare might be signing up millions of people who never had insurance before but it is going to be difficult in some places for them to find a doctor to treat them.
New York Post:
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J. Scott Applewhite / AP Photo
Marilyn Tavenner, the administrator of the Centers for Medicare and Medicaid Services, testifies on Capitol Hill in Washington, Tuesday, Oct. 29, 2013, before the House Ways and Means Committee hearing on the implementation of the Affordable Care Act. Stressing that improvements are happening daily, the senior Obama official closest to the administration’s malfunctioning health care website apologized Tuesday for problems that have kept Americans from successfully signing up for coverage.
Health policy cancellations: New blow for admin.
The Associated Press
WASHINGTON — Move over, website woes. Lawmakers confronted the Obama administration Tuesday with a difficult new health care problem — a wave of cancellation notices hitting small businesses and individuals who buy their own insurance.
At the same time, the federal official closest to the website apologized for its dysfunction in new sign-ups and asserted things are getting better by the day.
Medicare chief Marilyn Tavenner said it’s not the administration but insurers who are responsible for cancellation letters now reaching many of the estimated 14 million people who buy individual policies. And, officials said, people who get cancellation notices will be able to find better replacement plans, in some cases for less.
The Associated Press, citing the National Association of Insurance Commissioners, reported in May that many carriers would opt to cancel policies this fall and issue new ones. Administratively that was seen as easier than changing existing plans to comply with the new law, which mandates coverage of more services and provides better financial protection against catastrophic illnesses.
While the administration had ample warning of the cancellations, they could become another public relations debacle for President Barack Obama’s signature legislation. This problem goes to the credibility of one of the president’s earliest promises about the health care overhaul: You can keep your plan if you like it.
In the spring, state insurance commissioners started giving insurers the option of canceling existing individual plans for 2014, since the coverage required under Obama’s law is more robust. Some states directed insurers to issue cancellations. Large employer plans that cover most workers and their families are unlikely to be affected.
The cancellation notices are now reaching policyholders, and they’ve been complaining to their lawmakers — who were grilling Tavenner on Tuesday.
“Based on what little information the administration has disclosed, it turns out that more people have received cancellation notices for their health care plans this month than have enrolled in the (health care website),” said Ways and Means Chairman Dave Camp, R-Mich. He cited a news report of 146,000 cancellations in his state alone.
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NPR
New Security Issues Surface For Health Website
by The Associated Press
WASHINGTON (AP) — President Barack Obama claimed “full responsibility” Wednesday for fixing his administration’s much-maligned health insurance website as a new concern surfaced: a government memo pointing to security worries, laid out just days before the launch.
On Capitol Hill, Health and Human Services Secretary Kathleen Sebelius apologized to frustrated people trying to sign up, declaring that she is accountable for the failures but also defending the historic health care overhaul. The website sign-up problems will be fixed by Nov. 30, she said, and the gaining of health insurance will make a positive difference in the lives of millions of Americans.
Obama underscored the administration’s unhappiness with the problems so far: “There’s no excuse for it,” he said during a Boston speech to promote his signature domestic policy achievement. “And I take full responsibility for making sure it gets fixed ASAP.”
The website HealthCare.gov was still experiencing outages as Sebelius faced a new range of questions at the House Energy and Commerce Committee about a security memo from her department. It revealed that the troubled website was granted a temporary security certificate on Sept. 27, just four days before it went live on Oct. 1.
The memo, obtained by The Associated Press, said incomplete testing created uncertainties that posed a potentially high security risk for the website. It called for a six-month “mitigation” program, including ongoing monitoring and testing.
Security issues raise major new concerns on top of the long list of technical problems the administration is grappling with.
“You accepted a risk on behalf of every user … that put their personal financial information at risk,” Rep. Mike Rogers, R-Mich., told Sebelius, citing the memo. “Amazon would never do this. ProFlowers would never do this. Kayak would never do this. This is completely an unacceptable level of security.”
Sebelius countered that the system is secure, even though the site’s certificate, known in government parlance as an “authority to operate,” is of a temporary nature. A permanent certificate will be issued only when all security issues are addressed, she stressed.
Spokeswoman Joanne Peters added separately: “When consumers fill out their online … applications, they can trust that the information they’re providing is protected by stringent security standards and that the technology underlying the application process has been tested and is secure. Security testing happens on an ongoing basis using industry best practices.”
The security certificate is required under longstanding federal policy before any government computer system can process, store or transmit agency data. The temporary certificate was approved by Medicare chief Marilyn Tavenner, the senior HHS official closest to the rollout. No major security breaches have been reported.
The memo said, “From a security perspective, the aspects of the system that were not tested due to the ongoing development, exposed a level of uncertainty that can be deemed as a high risk for the (federal marketplace website).”
It recommended setting up a security team to address risks and conduct daily tests, and said a full security test should be conducted within two to three months of the website going live.
A separate page stated that “the mitigation plan does not reduce the risk to the (website) itself going into operation on October 1, 2013. However, the added protections do reduce the risk to the overall Marketplace operations and will ensure that the … system is completely tested within the next 6 months.”
That page was signed by three senior technical officials below Tavenner at the Centers for Medicare and Medicaid Services. All the officials deal with information security issues.
Republicans opposed to Obama’s health care law are calling for Sebelius to resign. She apologized to people having trouble signing up but told the committee that the technical issues that led to frozen screens and error messages are being cleared up on a daily basis.
Sebelius’ forthright statement about her ultimate accountability for problems with the sign-up rollout came as Rep. Marsha Blackburn, R-Tenn., peppered her with questions about the “debacle.”
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