ObamaCare Looking Like Medicaid; You May Be Insured, But Will The Doctor See You?

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Many, having signed up for ObamaCare with private health care coverage may be in for an unpleasant surprise; they’ll have insurance but they might have trouble getting the doctor to see them.

As hundreds or thousands, or even millions dependent on who you listen to, have enrolled for coverage beginning January 1, analysts are warning that the plans are likely to give them access to fewer doctors and hospitals. So much so, they warn that the system could begin to resemble Medicaid, the health care program for low-income Americans. “Indeed, I think this will eventually be like Medicaid,” said Merrill Matthews, director of the Council for Affordable Health Insurance.

Matthews said the only way many insurers are going to be able to control costs is by “simply clamping down on the amount they are willing to pay.” Just as with Medicaid, analysts warn that if payments get too low, many doctors might start refusing to see patients. That will leave more and more patients jockeying to see fewer and fewer doctors. They emphasize that having health insurance will not necessarily translate into access to health care.

“About half of the physicians in many communities refuse to take Medicaid patients because the payment system is just too low,” said James Capretta of the Ethics and Public Policy Center. Doug Holtz-Eakin, former director of the Congressional Budget Office suggested some of the plans on the exchanges are going in the same direction. “If you look at something where you get a dollar by treating a private payer, you get about 70 cents out of Medicare for that same treatment, and you get about 55 cents out of Medicaid for that,” he said. He added, “You know, ObamaCare started to look like Medicaid of the future, and in the Medicaid in the present, you can have the insurance but a doctor won’t see you.”

By the end of March, the Obama administration hopes to increase the number of people on Medicaid by 9 million and the number in private plans by 7 million. New Medicaid enrollments so far have far outpaced the enrollments in private plans on the exchanges. Since Medicaid patients already have access to relatively few doctors, expanding that population while opening the door to lower payments for private insurance raises the prospect of rationing, as too many people chase too few doctors.

The Obama administration for now is trying to move past a year of some ups and many downs for its health care law and encourage people to sign up during the final three months of open enrollment. President Obama said in his year-end press conference that enrollment has picked up considerably as problems with the federal exchange website have been addressed.

“The law is working: More than half a million Americans have enrolled through HealthCare.gov in the first three weeks of December alone – – and 800,000 more are on track to get Medicaid through their states,” he said in an email message on Sunday. Obama continued to stress that the law is providing health insurance to those previously unable to get it. “Now, thousands of Americans are signing up for coverage every day. That matters. It means financial security for families all across the country. It means freedom from the fear that one illness or accident might cost you everything you’ve worked so hard to build.”

I have to admit confusion as to how having insurance when nobody will accept it, or you can’t get to those that do, due to long waiting periods exactly helps that much. As for the financial security, many are finding out that their new private policies have such high deductibles before insurance even kicks in is just to cost prohibitive to see a doctor anyway.

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Rick Stambaugh
After serving in the United States Navy for 22 years I retired from the service late in 1991. Having always loved the southwest, shortly after retiring, I moved to the Albuquerque area where I have resided since. Initially I worked as a contractor for approximately 6 years doing cable construction work. That becoming a little dangerous, at an elevated age, I moved into the retail store management environment managing convenience stores for roughly 16 years. With several disabilities, I am now fully retired and am getting more involved with helping Pastor Dewey & Pastor Paul with their operations at FGGAM which pleases my heart greatly as it truly is - "For God's Glory Alone". I met my precious wife Sandy here in Albuquerque and we have been extremely happily married for 18 years and I am the very proud father to Sandy's wonderful children, Tiana, our daughter, Ryan & Ross, our two sons, and proud grandparents to 5 wonderful grandchildren. We attend Christ Full Deliverance Ministries in Rio Rancho which is lead by Pastor's Marty & Paulette Cooper along with Elder Mable Lopez as regular members. Most of my time is now spent split between my family, my church & helping the Pastors by writing here on the FGGAM website and doing everything I can to support this fantastic ministry in the service of our Lord. Praise to GOD & GOD Bless to ALL! UPDATED 2021: Rick and Sandy moved to Florida a few years ago. We adore them and we pray for Rick as he misses Sandy so very, very much!

4 COMMENTS

  1. When I signed up for my ACA plan, the four doctors I wanted to see were documented as being on the panel.

    I got my member ID today, and three out of the four are not taking any ACA plan coverage. They just aren’t. One MD told me the negotiated payments are just too low, don’t cover expenses.

    My plan has no local hospital on the panel. The closest is at least 20 minutes away by car, in no traffic. Great in an emergency.

    I can’t find a family practice doc…all the ones I’ve called that are listed on the panel are refusing my insurance.

    Why do so few people know what’s going on? This is so stressful and awful!

    • I certainly understand your disappointment and frustration Sue.
      I fear it has yet to get worse, in this respect and many, many more.
      ‘One’ of my many fears with the ACA was just exactly this.
      We here at FGGAM pray for you and all those going through this extremely unfortunate situation.
      Hopefully, following our mid-term elections we’ll be able to place some people in office who can actually get something done about it.
      Thank You for your comments.

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