From U. S. News and World Report:
Though top-ranked hospitals like Case Medical Center accept plans from dozens of private insurers, if you buy your insurance on the Obamacare exchanges your options for treatment may be limited.
The Obama Administration has been claiming that insurance companies will be competing for your dollars under the Affordable Care Act, but apparently they haven't surveyed the nation's top hospitals.
Americans who sign up for Obamacare will be getting a big surprise if they expect to access premium health care that may have been previously covered under their personal policies. Most of the top hospitals will accept insurance from just one or two companies operating under Obamacare.
[CHART: Which Top Hospitals Take Your Insurance Under Obamacare?]
"This doesn't surprise me," said Gail Wilensky, Medicare advisor for the second Bush Administration and senior fellow for Project HOPE. "There has been an incredible amount of focus on the premium cost and subsidy, and precious little focus on what you get for your money."
Regulations driven by the Obama White House have indeed made insurance more affordable – if, like Health and Human Services Secretary Kathleen Sebelius, you're looking only at price. But responding to Obamacare caps on premiums, many insurers will, in turn, simply offer top-tier doctors and hospitals far less cash for services rendered.
Watchdog.org looked at the top 18 hospitals nationwide as ranked by U.S. News and World Report for 2013-2014. We contacted each hospital to determine their contracts and talked to several insurance companies, as well.
The result of our investigation: Many top hospitals are simply opting out of Obamacare.
Chances are the individual plan you purchased outside Obamacare would allow you to go to these facilities. For example, fourth-ranked Cleveland Clinic accepts dozens of insurance plans if you buy one on your own. But go through Obamacare and you have just one choice: Medical Mutual of Ohio.
And that's not because their exchanges don't offer options. Both Ohio and California have a dozen insurance companies on their exchanges, yet two of the states' premier hospitals – Cleveland Clinic and Cedars-Sinai Medical Center – have only one company in their respective networks.
A few, like No. 1-rated Johns Hopkins in Maryland, are mandated under state law to accept all insurance companies. Other than that, the hospital with the largest number of insurance companies is University Hospitals Case Medical Center in Cleveland with just four. Fully 11 of the 18 hospitals had just one or two carriers.
"Many companies have selectively entered the exchanges because they are concerned that (the exchanges) will be dominated by risky, high-using populations who wanted insurance (before Obamacare) and couldn't afford it," said Wilsensky, who is also on the board of directors of UnitedHealth. "They are pressed to narrow their networks to stay within the premiums."
Consumers, too, will struggle with the new system. Many exchanges don't even list the insurance companies on their web sites. Some that do, like California, don't provide names of doctors or hospitals.
The price differences among hospitals "can be pretty profound," said Joe Mondy, spokesman for Cigna insurance. "When you are doing a cost comparison with doctors, you should look up the quality of the hospital as well. Hospital 'Y' could be great at pediatrics and not great at surgery."
Insurers operating in the exchanges are apparently hesitant to talk about the trade-off between price and quality. Two of the nation's largest insurers – Wellpoint and Aetna – refused to respond to a dozen calls and emails placed over the course of a week.
Wellpoint and Aetna's decision to not educate the public on its choices doesn't sit well with two experts.
"There is no reason to keep that quiet. It's not going to be a good secret for very long when people want to use the plans," Wilensky said.
"In many cases, consumers are shopping blind when it comes to what doctors and hospitals are included in their Obamacare exchange plans," said Josh Archambault, senior fellow with the think tank Foundation for Government Accountability. "These patients will be in for a rude awakening once they need care, and get stuck with a big bill for going out-of-network without realizing it."
All of this represents a larger problem with the Affordable Care Act, said Archambault, who has extensively studied the law.
"It reflects deeper issues in implementation," he said. "Some hospitals and doctors don't even know if they are in the network."
Just look at Seattle Children's Hospital, which ranks No. 11 on the U.S. News & World Report best pediatric hospital list. When Obamacare rolled out, the hospital found itself with just two out of seven insurance companies on Washington's exchange. The hospital sued the state's Office of Insurance on Oct. 4 for "failure to ensure adequate network coverage."
"Children's is the only pediatric hospital in King County and the preeminent provider of many pediatric specialty services in the Northwest," a hospital press release said. " Some of these specialized services not available elsewhere in our area or region include acute cancer care, level IV neonatal intensive care and heart, liver and intestinal transplantation."
And for doctors in Texas, "Basically, we don't know," said Stephen Brotherton, president of the Texas Medical Association. "We can't find out. At this point, it's part of the various unknowns with the marketplace. There are ways you can be on plans and not even realize it."
Tori Richards is a writer with Watchdog.org. Contact her at tori@watchdog.org or on Twitter: @newswriter2.
Originally posted by vivifyThat's a typically distorted response. Normal for you. People are forced to buy health insurance. Those pesky doctors and hospitals though, not playing along with Obama...and the point of the story, dense one, is Obamacare is reducing, not expanding, health care options for people.
They opted out? Kinda puts to rest all those "communist" claims from the right, since no one's forced to do anything.
God I'm enjoying this.
Originally posted by sasquatch672I think 95% of the blame for this mess can be traced back to President Obama himself. President Obama has been so focused on the legal details, he seems to have lost sight of fact that making this program available to the general public is a multi faceted, and complicated effort. Clearly the website mess has been a headache, but President Obama is responsible for this program...all of it. He should have spent more time with the website folks, and made sure of it's reliability before launching it.
From U. S. News and World Report:
Though top-ranked hospitals like Case Medical Center accept plans from dozens of private insurers, if you buy your insurance on the Obamacare exchanges your options for treatment may be limited.
The Obama Administration has been claiming that insurance companies will be competing for your dollars under the ...[text shortened]... rds is a writer with Watchdog.org. Contact her at tori@watchdog.org or on Twitter: @newswriter2.
I would caution Mr. Sasquatch and others who are finding joy at this programs flaws. The Affordable care act was launched with the intention of making healthcare more accessable and affordable to those who don't have it, and and in many cases it has, flaws aside however, if you folks think Insurance Companies and HMO's exist to make your healthcare situation better and more affordable, think again. If these giant corporations think they can get away with scamming the general public for profit, they'll do it, and they don't give a hoot about you or your loved ones. So please consider this before getting too smug about this programs demise. 😏
Originally posted by bill718I've seen firsthand how much insurance companies can suck. I'm not rooting for insurance companies. My mother initially had more chemotherapy denied, until the CEO of her company told the insurance company they were dropping their plan.
I think 95% of the blame for this mess can be traced back to President Obama himself. President Obama has been so focused on the legal details, he seems to have lost sight of fact that making this program available to the general public is a multi faceted, and complicated effort. Clearly the website mess has been a headache, but President Obama is responsibl ...[text shortened]... al public for profit, they'll do it, and they don't give a hoot about you or your loved ones! 😏
But what Obama has done is take an admirable and achievable goal, throw his a-hole personality in the mix let's face it - he's a beta male a-hole), add in a few hundred tons of sneering moral superiority, throw in a couple aircraft carriers full of dismissiveness and incompetence, and turn that very admirable and achievable goal into an issue over which even his former allies are turning on him. It's beautiful, in its own way - an unprecedented and transcendent piece of douchebaggery that perplexingly seems designed to destroy what was left of his shredded credibility.
And if Obama was paying attention to the legal details, well - he needs to go get another attorney. The ACA is such a legal mess that it's still unclear whether it can survive several looming legal challenges.
Originally posted by sasquatch672Well...if making healthcare available and more affordable to the millions who don't have it is "an admirable and achievable goal" please explain to us how you would achieve it.
I've seen firsthand how much insurance companies can suck. I'm not rooting for insurance companies. My mother initially had more chemotherapy denied, until the CEO of her company told the insurance company they were dropping their plan.
But what Obama has done is take an admirable and achievable goal, throw his a-hole personality in the mix let's ...[text shortened]... ch a legal mess that it's still unclear whether it can survive several looming legal challenges.
Originally posted by bill718I'll tell you what I wouldn't do. I wouldn't make a 54-year old woman buy maternity insurance. You do realize that millions more people are having their insurance cancelled than are able to buy health insurance?
Well...if making healthcare available and more affordable to the millions who don't have it is "an admirable and achievable goal" please explain to us how you would achieve it.
The ACA has been on the books for more than three years, and it's as cocked up a bill that has ever existed. I'm going to claim my right to a little time before I answer you.
Originally posted by bill718Obamacare was launched by the Democrats only so that they could bring about a single payer system that will totally bankrupt this country.
I think 95% of the blame for this mess can be traced back to President Obama himself. President Obama has been so focused on the legal details, he seems to have lost sight of fact that making this program available to the general public is a multi faceted, and complicated effort. Clearly the website mess has been a headache, but President Obama is responsibl ...[text shortened]... your loved ones. So please consider this before getting too smug about this programs demise. 😏
Obama and his ilk believe that the US needs to be brought down a peg or three for some reason.
Originally posted by EladarBecause liberals hate freedom.
Obamacare was launched by the Democrats only so that they could bring about a single payer system that will totally bankrupt this country.
Obama and his ilk believe that the US needs to be brought down a peg or three for some reason.
They hate Freedom of Speech, as the IRS has amply demonstrated.
They hate freedom of religion - Sandra Fluke, anyone?
They hate freedom of the press - examples too numerous to mention.
They hate the ability of the American people to arm themselves, because that gives us the ability to resist their godless, Marxist, communist, authoritarian, totalitarian initiatives.
They hate privacy, as the NSA has demonstrated.
They love the right against self-incrimination, as Lois Lerner showed. That's a good one for them.
They hate the right to a speedy and public trial - Obama has summarily executed Americans in drone attacks.
They hate the prohibition of cruel and unusual punishment - after all, Obama has killed Americans in drone attacks.
And they hate states' rights - again, too many examples to list here.
How many separate violations of the Constitution has Obama committed? If a Republican president committed a tenth of his high crimes, the Marxist, anti-American mainstream media would be baying for blood.
Originally posted by bill718Good intentions don't get things done. Obama, prior to the Presidency had never administered a Popsicle stand. Not an iota of business experience, and yet he took this plan (?) out of some staffer's drawer and got it passed, and now he's surprised it doesn't work? He lied about it and continues trying to justify the original lies with new ones. When will he take ownership of the screwups?
I think 95% of the blame for this mess can be traced back to President Obama himself. President Obama has been so focused on the legal details, he seems to have lost sight of fact that making this program available to the general public is a multi faceted, and complicated effort. Clearly the website mess has been a headache, but President Obama is responsibl ...[text shortened]... your loved ones. So please consider this before getting too smug about this programs demise. 😏
Originally posted by bill718Health care and free health care, insurance for uninsurable things are different objectives. It appears now that the 40 million who were not insured before the ACA will be small potatoes to those who will be uninsured afterwards.
Well...if making healthcare available and more affordable to the millions who don't have it is "an admirable and achievable goal" please explain to us how you would achieve it.
Good intentions don't count for spit.
Originally posted by sasquatch672You spend all this time obsessing about a health care law, and you haven't even thought about what would be the best way to deal with the issue?
I'll tell you what I wouldn't do. I wouldn't make a 54-year old woman buy maternity insurance. You do realize that millions more people are having their insurance cancelled than are able to buy health insurance?
The ACA has been on the books for more than three years, and it's as cocked up a bill that has ever existed. I'm going to claim my right to a little time before I answer you.
Originally posted by KazetNagorraHey I'm one guy. All of the meatheads in DC that wrote this cocked-up POS couldn't get it right. So why don't you give me just a little room?
You spend all this time obsessing about a health care law, and you haven't even thought about what would be the best way to deal with the issue?
Originally posted by KazetNagorraFor starters keep government out of it altogether. For another recognize the medical and insurance scam for what it is. The insurance companies basically drove the costs up by carefully paying out more than the procedure should cost. So long as they did it over enough time and balanced it to where they could still profit, the average person was unable to pay without insurance because of the inflated costs. Now the insurance companies have won and got the government involved so we now are their slaves. Social medicine is one thing and fascist is another.
You spend all this time obsessing about a health care law, and you haven't even thought about what would be the best way to deal with the issue?