The Clinton Herald, Clinton, Iowa

Food & Health

May 14, 2014

Consumers losing doctors with new insurance plans

MIAMI — Some consumers who bought insurance under President Barack Obama's health care law are experiencing buyer's remorse after realizing that their longtime doctors aren't accepting the new plans.

Before the law took effect, experts warned that narrow networks could impact patients' access to care, especially in cheaper plans. But with insurance cards now in hand, consumers are finding their access limited across all price ranges — sometimes even after they were told their plan would include their current doctor.

Michelle Pool is one of those customers. Before enrolling in a new health plan on California's exchange, she checked whether her longtime primary care doctor was covered. Pool, a 60-year-old diabetic who has had back surgery and a hip replacement, purchased the plan only to find that the insurer was mistaken.

Her $352 a month gold plan was cheaper than what she'd paid under her husband's insurance and seemed like a good deal because of her numerous pre-existing conditions. But after her insurance card came in the mail, the Vista, California resident learned her doctor wasn't taking her new insurance.

"It's not fun when you've had a doctor for years and years that you can confide in and he knows you," Pool said. "I'm extremely discouraged. I'm stuck."

The dilemma undercuts President Obama's 2009 pledge that: "If you like your doctor, you will be able to keep your doctor, period." Consumer frustration over losing doctors comes as the Obama administration is still celebrating a victory with more than 8 million enrollees in its first year.

Narrow networks are part of the economic trade-off for keeping premiums under control and preventing insurers from turning away those with pre-existing conditions. Even before the Affordable Care Act, doctors and hospitals would choose to leave a network — or be pushed out — over reimbursement issues as insurers tried to contain costs.

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