Forget the plan – let patients keep their doctors!

I think there are two important points that are missing from the intense media focus — and now the White House response – to the problem of the insurance cancellation notices on the individual market.  Both are the result of actions that have been taken by insurance companies which are now participating in the exchanges — in other words, they are barriers to acceptance of ACA created by the same insurance companies that are the chief beneficiaries of the new, heavily subsidized insurance market.

The promise that “if you like your insurance, you can keep your insurance” was essentially written into the law, by the express terms of the original ACA legislation. There was a “grandfather” clause which expressly allowed consumers to keep whatever plans they were enrolled in prior to March of 2010, subject to some requirements to strengthen those plans.

The problem is that many consumers who buy their own insurance on the market have switched plans since then, giving up their grandfathered status.  It’s not that they didn’t like the plans they had; rather, those plans got too expensive. So very often the switch was to another, seemingly better or less expensive plan offered by the same company.   

A website that works

Frustrated with Healthcare.gov? It turns out that there’s another web site where the federal government stores data about the plans from the states. It’s not fancy, but it works.

Here’s a link:

https://data.healthcare.gov/dataset/QHP-Individual-Medical-Landscape/ba45-xusy

Covered California web site

I tried to access the Covered California portal today to look at that provider list they promised to load on “October 7”.   Here’s where I ended up:

From Covered California Web Site 7 October

Don’t see your doctor’s name? WAIT

Here in California, one cause of confusion and frustration is the lack of adequate information about which doctors and facilities are included on each insurer’s plan. The bottom line: that information was not ready for dissemination when the exchanges launched on October 1. 

I don’t know if this is true for other state exchanges but I assume that the problem may be widespread.

Covered California has announced that the  composite (all carrier) provider directory will be available on Monday, October 7, 2013

Anthem Blue Cross/ Blue Shield has a notice on the home page of its website that says that they are updating their online list of doctors and hospitals and that we should wait until “next week.”  An Anthem sales agent told me that “next week” might mean Tuesday, October 8th.  At least that is what the agents were told in a meeting.

Blue Shield of California doesn’t have any friendly notices on its website, but an agent confirmed to me last week that the directories for the new plans are not yet up to date.