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Sorry, We Don't Take Obamacare

LowDown

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New York Times:

AMY MOSES and her circle of self-employed small-business owners were supporters of President Obama and the Affordable Care Act. They bought policies on the newly created New York State exchange. But when they called doctors and hospitals in Manhattan to schedule appointments, they were dismayed to be turned away again and again with a common refrain: “We don’t take Obamacare,” the umbrella epithet for the hundreds of plans offered through the president’s signature health legislation.

“Anyone who is on these plans knows it’s a two-tiered system,” said Ms. Moses, describing the emotional sting of those words to a successful entrepreneur.

In the average Obamacare policy only about 25% of the physicians in a given area are included in the plan's network. I would imagine that none of the doctors or hospitals in Manhattan are in any of these plans. Instead you go to a clinic in Queens or whatnot for your care. Obamacare policies typically will not cover out of network care at all. Most plans gotten from employers includes some coverage for out of network care.

There is probably also a realization among Manhattan clinics that Obamacare patients are not good for the out of pocket expenses. If the patients had to get a subsidy to afford the policy in the first place it's unlikely that they are going to have the money for a co-pay.

So there is a level of care you get with regular insurance, which includes Manhattan doctors, and there is Obamacare. It's pretty much the same as before, when we had insured care and uninsured care, and you could only get the latter at certain government supported hospitals. I suppose Obamacare is an improvement over care through a county health care system, but it's probably not as much of an improvement as people had hoped.

When all this started, way back in 2009, I said that with or without the ACA poor people would continue to get their health care at the same places. The only difference would be that they'd be able to claim they had health insurance. This is literally true for those who are on Medicaid, but it's also turning out to be true for the rest of Obamacare as well.
 

joG

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New York Times:



In the average Obamacare policy only about 25% of the physicians in a given area are included in the plan's network. I would imagine that none of the doctors or hospitals in Manhattan are in any of these plans. Instead you go to a clinic in Queens or whatnot for your care. Obamacare policies typically will not cover out of network care at all. Most plans gotten from employers includes some coverage for out of network care.

There is probably also a realization among Manhattan clinics that Obamacare patients are not good for the out of pocket expenses. If the patients had to get a subsidy to afford the policy in the first place it's unlikely that they are going to have the money for a co-pay.

So there is a level of care you get with regular insurance, which includes Manhattan doctors, and there is Obamacare. It's pretty much the same as before, when we had insured care and uninsured care, and you could only get the latter at certain government supported hospitals. I suppose Obamacare is an improvement over care through a county health care system, but it's probably not as much of an improvement as people had hoped.

When all this started, way back in 2009, I said that with or without the ACA poor people would continue to get their health care at the same places. The only difference would be that they'd be able to claim they had health insurance. This is literally true for those who are on Medicaid, but it's also turning out to be true for the rest of Obamacare as well.

That cannot be true? The ACA plans only cover local treatment?
 

jmotivator

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New York Times:



In the average Obamacare policy only about 25% of the physicians in a given area are included in the plan's network. I would imagine that none of the doctors or hospitals in Manhattan are in any of these plans. Instead you go to a clinic in Queens or whatnot for your care. Obamacare policies typically will not cover out of network care at all. Most plans gotten from employers includes some coverage for out of network care.

There is probably also a realization among Manhattan clinics that Obamacare patients are not good for the out of pocket expenses. If the patients had to get a subsidy to afford the policy in the first place it's unlikely that they are going to have the money for a co-pay.

So there is a level of care you get with regular insurance, which includes Manhattan doctors, and there is Obamacare. It's pretty much the same as before, when we had insured care and uninsured care, and you could only get the latter at certain government supported hospitals. I suppose Obamacare is an improvement over care through a county health care system, but it's probably not as much of an improvement as people had hoped.

When all this started, way back in 2009, I said that with or without the ACA poor people would continue to get their health care at the same places. The only difference would be that they'd be able to claim they had health insurance. This is literally true for those who are on Medicaid, but it's also turning out to be true for the rest of Obamacare as well.

We've heard warnings of this for a long time, and now that the system is in place all of these warnings are proving true.

The law had so many strikes against it from the get go that they had to walk a fine line to avoid losing votes.

What they couldn't do when the bill was written was require doctors to accept Obamacare plans. We were already barreling towards a doctor crisis with so many older doctors retiring and a shrinking group of young doctors to replace them. The medical field is still stacked with doctors, but not in general practice where it is hardest to make a good living.

Medicaid and Medicare recipients already see enrollment issues with many doctors putting strict limits on the number of Medicare and Medicaid patients they will see. No shock that the same is being seen with ACA plans.
 

Deuce

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It seems odd to me that BlueCross can negotiate an acceptable rate for a plan off the exchange but not one on the exchange.
 
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