WASHINGTON – A group of physicians and health policy experts warned Congress some Americans might begin to see smaller provider networks and higher premiums under the nation’s new healthcare law.
Chairman of the House Oversight and Government Reform Committee Darrell Issa (R-Calif.) held another hearing last week on the impact of the Affordable Care Act. In the last few months, the committee has embarked upon an examination of the details of how the ACA was implemented, along with the troubled rollout of the online health insurance marketplace.
This time the committee convened a panel of physicians and healthcare experts to scrutinize the impact of Obamacare on provider networks and reports that the healthcare law is increasing insurance costs.
Dr. Patricia McLaughlin, an ophthalmologist based in New York City, said insurers are introducing limited networks and announcing new plans that will offer only in-network benefits, excluding all out-of-network doctors.
She noted the problem of limited networks is that many health plans have substantially reduced or eliminated previous coverage options that allowed patients to see the doctor of their choice.
“No patient should have to give up all the doctors that they trust and have had longstanding doctor-patient relationships over many years,” McLaughlin said. “This has turned into a house of cards about to fall affecting the lives of millions and severing doctor-patient relationships over and over again.”
McLaughlin told the committee she could lose 20 percent of her current patients due to the cancellation of most out-of-network coverage under the ACA.
Dr. Jeffrey English, a neurologist at the Multiple Sclerosis Center of Atlanta, said the law punishes doctors like him because he recommends too many costly procedures, such as MRIs and brain-image scans, compared to his peers.
“In reward for my passions to prevent real people from becoming disabled, CMS and insurance companies like United Healthcare are going to post negative grades in my name,” he said. “They will financially penalize me or the institution I work for, as I am trying to practice quality care to some of our most vulnerable patients.”
Rep. Gerry Connolly (D-Va.) complained that Republicans on the committee had cherry-picked doctors who held negative views of Obamacare and had refused to allow more supportive witnesses to testify. “The idea that your experience is to be generalized as universal is false. And it does a disservice, in my opinion, to this discussion,” Connolly told the witnesses. “None of you are policy experts. And none of you universally speak for your profession.”
Issa replied the Democrats had not suggested any doctors for the panel, and the only witness they had requested was a policy expert.
Avik Roy, a senior fellow at the conservative Manhattan Institute, said the ACA taxes premiums, pharmaceuticals, and medical devices in a manner that has the net effect of increasing the cost of insurance.
He noted sicker and older individuals have “a compelling economic incentive” to enroll in the ACA marketplaces, while healthier and younger individuals have a smaller incentive, creating adverse selection in the system.
Roy urged lawmakers to adopt legislation that would require the Human and Health Services Department to provide weekly updates on exchange enrollment statistics. He said this would help monitor adverse selection.
Roy said research by the Manhattan Institute shows that underlying premiums will increase by an average of 41 percent across the nation. Among the states seeing large increases are Nevada (179%), New Mexico (142%), North Carolina (136%), and Vermont (117%).
The analysis also found that eight states will see average premiums decreased under the law, including New York (-40%), Ohio (-21%), and Massachusetts (-20%).