As the second anniversary of Obamacare’s launch draws near, the law has neither improved care nor lowered costs.
One measure of Obamacare’s performance is the monthly premium that patients pay. It has gone up, quite sharply in many states, but premiums are not the only indicator of cost. Premiums would have gone much higher if insurers, preparing themselves for Obamacare, had not found other ways to keep them from looking like monthly mortgage payments.
One method was to hike deductibles. This means that even though the law guarantees a few insignificant freebies for people who are healthy, Obamacare has made serious illnesses and accidents more expensive than they used to be.
The other main method insurers have used to keep premiums down is more insidious and harder for exchange customers to detect until it is too late. They have narrowed their provider networks, which means your insurance restricts your choice of doctors and hospitals.
A new report details the drastic lengths to which insurers have gone to narrow their networks to adapt to Obamacare. University of Pennsylvania researchers looked at 1,000 Obamacare exchange plans nationwide, all in the middle or “Silver” category. They found that 41 percent of these plans nationwide offered provider networks that included fewer than one in four local doctors. In some states, the access problem is much more acute. In California, a state that has been patting itself on the back for keeping premiums increases mild, 75 percent of plans offer such narrow networks.
Narrow-access Silver plans are the norm in other large states such as Georgia (83 percent of plans), Florida (79 percent), and Texas (73 percent).
Narrow access means longer waits and more difficulty in securing appointments. A Kaiser Family Foundation survey found that nearly one-fifth of Obamacare exchange users were unable to find a doctor who would agree to take them as a new patient.
In some places, including Washington State and New Hampshire, patients suddenly discovered that they were barred from the best hospitals for treating their condition, or forced to travel for hours to reach a provider in their network. The result is that one can find the newly insured saying such things as, “I’m truly grateful we have insurance. It’s reasonable and affordable, but it’s not doing me a lot of good.”
This phenomenon is known as access shock, and it’s something Obamacare’s opponents predicted long ago. The Obama administration acknowledged it as a problem when its regulators proposed “network adequacy” rules. But of course such rules will also make premiums rise.
Obamacare cannot defeat the laws of economics, and there is nothing so expensive as low-cost health care.
