Obamacare Plans Offer 34 Percent Fewer Choices
As many predicted, Americans insured under the Affordable Care Act may not be able to keep their doctors--and even their hospitals.
A new study reveals that the average plans provided on the Obamacare health insurance exchanges offer 34 percent fewer providers than the average commercial plan offered outside the exchange.
The analysis from Avalere shows the disparity compared with commercial plans:
- 42 percent fewer oncology and cardiology specialists
- 32 percent fewer mental health and primary care providers
- 24 percent fewer hospitals
Related: Top 10 Questions Consumers Ask About Obamacare
“Patients should evaluate a plan’s provider network when picking insurance on the exchange,” said Elizabeth Carpenter, vice president at Avalere. “Out-of-network care does not accrue toward out-of-pocket maximums, leaving consumers vulnerable to high costs if they seek care from a provider not included in their plan’s network.”
Patients need to evaluate a plan’s provider network when selecting insurance on the exchange, especially if they have a history of cancer or heart disease or require mental health services.
Limiting choice is one way for health exchanges to keep costs down, but ultimately patients bear the cost. “Plans continue to test new benefit designs in the exchange market,” said Dan Mendelson, CEO at Avalere. “Given the new requirements put in place by the ACA, network design is one way plans can drive value-based care and keep premiums low.”
Increasing Number of Americans Delay Medical Care Due to Cost: Gallup
From Gallup: “A record 25% of Americans say they or a family member put off treatment for a serious medical condition in the past year because of the cost, up from 19% a year ago and the highest in Gallup's trend. Another 8% said they or a family member put off treatment for a less serious condition, bringing the total percentage of households delaying care due to costs to 33%, tying the high from 2014.”
Number of the Day: $213 Million
That’s how much the private debt collection program at the IRS collected in the 2019 fiscal year. In the black for the second year in a row, the program cleared nearly $148 million after commissions and administrative costs.
The controversial program, which empowers private firms to go after delinquent taxpayers, began in 2004 and ran for five years before the IRS ended it following a review. It was restarted in 2015 and ran at a loss for the next two years.
Senate Finance Chairman Chuck Grassley (R-IA), who played a central role in establishing the program, said Monday that the net proceeds are currently being used to hire 200 special compliance personnel at the IRS.
US Deficit Up 12% to $342 Billion for First Two Months of Fiscal 2020: CBO
The federal budget deficit for October and November was $342 billion, up $36 billion or 12% from the same period last year, the Congressional Budget Office estimated on Monday. Revenues were up 3% while outlays rose by 6%, CBO said.
Hospitals Sue to Protect Secret Prices
As expected, groups representing hospitals sued the Trump administration Wednesday to stop a new regulation would require them to make public the prices for services they negotiate with insurers. Claiming the rule “is unlawful, several times over,” the industry groups, which include the American Hospital Association, say the rule violates their First Amendment rights, among other issues.
"The burden of compliance with the rule is enormous, and way out of line with any projected benefits associated with the rule," the suit says. In response, a spokesperson for the Department of Health and Human Services said that hospitals “should be ashamed that they aren’t willing to provide American patients the cost of a service before they purchase it.”
See the lawsuit here, or read more at The New York Times.
A Decline in Medicaid and CHIP Enrollment
Between December 2017 and July 2019, enrollment in Medicaid and the Children's Health Insurance Program (CHIP) fell by 1.9 million, or 2.6%. The Kaiser Family Foundation provided an analysis of that drop Monday, saying that while some of it was likely caused by enrollees finding jobs that offer private insurance, a significant portion is related to enrollees losing health insurance of any kind. “Experiences in some states suggest that some eligible people may be losing coverage due to barriers maintaining coverage associated with renewal processes and periodic eligibility checks,” Kaiser said.
