Friday, December 6, 2013

Things Are Going to Get Much Worse in January When You Can't See Your Doctor

Come January, when some number of Americans have bought insurance on the new health exchanges and are starting to use the services, you can expect another controversy to arise when many of them find out just how few doctors and hospitals they have access to. Call it “doc shock,” though the biggest outcry will not come when people try to schedule an appointment with their physician, but when someone gets sick and they learn they cannot go to whatever top-notch hospital they want, only to the hospital that is included in their plan.  
The problem varies across the country. In Washington, where I live, it basically won’t be a problem at all; exchange policies have mostly the same provider networks as regular policies from those insurers. On the other end of the spectrum, in California, where the exchange put heavy pressure on insurers to keep premiums low, most exchange policies have bare-bones coverage that excludes top-tier hospitals such as UCLA and Cedars-Sinai. The industry calls these “narrow network” plans, but consumers are likely to have some more pungent names for the stripped-down provider offerings.  
In those places where insurers are narrowing their networks, it’s likely to become a big issue -- not just a public-relations one, but legal. Seattle Children’s Hospital is already suing over its exclusion from most of the area’s exchange policies....