Some consumers lose longtime doctors in new plans

May 15 2014

Insurers say narrow networks that exclude some providers are part of the trade-off for keeping down premiums and enrolling those with pre-existing conditions. Other media outlets offer consumers advice on getting a procedure or drug covered and examine the law's impact on doctors' offices and small businesses.

The Associated Press: Consumers Losing Doctors With New Insurance Plans
Before the law took effect, experts warned that narrow networks could impact patient's access to care, especially in cheaper plans. But with insurance cards now in hand, consumers are finding their access limited across all price ranges. The dilemma undercuts President Obama's 2009 pledge that: "If you like your doctor, you will be able to keep your doctor, period." ... Narrow networks are part of the economic trade-off for keeping premiums under control and preventing insurers from turning away those with pre-existing conditions (5/13). 

Fox News: How To Get Your Health Provider To Cover Something Not On Your Plan
Getting a health insurer to cover something that isn't part of your plan is tricky-;but not impossible. "It is possible to get coverage, but it takes a lot of work on the customer's side," says Carrie Mclean, director of customer care at eHealthInsurance. Whether it's medication, a procedure or any other treatment, "making it clear that the doctor is recommending this and that it's medically necessary can really help," she adds (Fuscaldo, 5/13).

Minnesota Public Radio: Q&A With Dr. Hallberg: The Effects Of ACA In The Doctor's Office
The White House has said 8 million people signed up by mid-April for private health insurance through the new exchanges. It's not clear how many of them are newly insured, but primary care providers around the nation are reportedly seeing more patients through the doors as a result of the Affordable Care Act. Dr. Jon Hallberg, a physician in family medicine at the University of Minnesota and medical director of the Mill City Clinic in Minneapolis came by to discuss how the new health care law is playing out in the doctor's office (5/13).

Meanwhile, media outlets look at the first premium proposals for 2015 and the law's impact on small businesses -

The Washington Post's Wonkblog: One Health Insurer Wants To Cut Rates 6.8 Percent. Another Wants To Hike Them 26 Percent. What Gives?
The first Obamacare enrollment period barely just ended, and it's already time for insurers in some states to file information on premiums for 2015. The 2014 rate filings last year became major political stories in a non-election year, so it's safe to assume the same will happen this year. And the 2015 rates will give us a glimpse into the future of the health-care industry (Millman, 5/13).

Kaiser Health News: Brew Pub Owner Frustrated That Health Plan Prices Still Jumping
Until now, if employees were healthy and claims were few (as they are at Fat Head's), the company's cost of insuring those employees was relatively low. But, for a small business, if even one employee was in a car accident or was diagnosed with cancer, the amount the insurance company charged the firm to cover those employees could skyrocket the next year. The insurance industry called this "experience rating," and it is changing under the health law, says Steve Millard, who heads a small business association in Cleveland (Tribble, 5/14).

The Washington Post: What's Obamacare Doing In A Debate Over Fairfax County Water Agency Appointee? 
The national debate over the Affordable Care Act seemed an unlikely topic of discussion at Tuesday's meeting of the Fairfax County Board of Supervisors -- especially since the item on the agenda was whether to reappoint a longtime member of the local water authority. Yet the law was what the supervisors focused on, specifically a letter to members of Congress written last fall by water board veteran Burton J. Rubin, warning that the insurance requirements of the Affordable Care Act would cause the water authority to stop insuring its employees (Olivo, 5/13).