As the Obama administration touts eight million Obamacare signups this spring, a small number of enrollees are experiencing a new problem described as “medical homelessness.” After the closing of open enrollment for coverage under the Affordable Care Act (ACA), some new beneficiaries find they’ve enrolled in insurance but cannot find a new doctor.
Clinician Mirella Nguyen says former clients of Rotacare, a free health clinic for the poor in Mountain View, Calif., are reappearing after purchasing coverage on the online health insurance exchange. Though clinic rules forbid treating patients with insurance, the health care worker told CBS this week they understood the distinction was meaningless in some cases.
“They’re coming back to us now and saying I can’t find a doctor,” Nguyen said. Among such patients at the clinic were Thinn Ong, who pays $200 per month in premiums for a federally subsidized health coverage policy. “Yeah, I sign it. I got it. But where’s my doctor? Who’s my doctor? I don’t know,” she said about her coverage. Like others, the plan lacks enough doctors to go around.
Physicians on the provider list given to policyholders said they either weren’t accepting new patients or did not participate in the coverage plan. Kevin Grumbach, a doctor at the University of California, San Francisco, said such “medical homelessness” might be growing as a problem. Although California officials deny a provider shortage at the moment, experts say a third of the state’s primary care physicians may soon retire — just as another three million state residents gain insurance under the ACA.
Aside from insured patients lacking doctors, some experts worry about a second short-term problem that might develop in the early months and years of the ACA, as reported by The Washington Post. With discrimination against those with pre-existing conditions now illegal, some insurance companies might scheme to limit liability by employing de facto methods of screening for sick enrollees. To do so, some insurance companies might simply choose to deny coverage for conditions, as opposed to beneficiaries with conditions. It’s not you; it’s the HIV/AIDS we’re not covering. Experts say federal officials are still allowing too many coverage decisions to be regulated by state and local officials, leaving some loopholes.
Congressmen moved quickly this month to “fix” an aspect of the new health law affecting the small businessman, who is the darling of both major parties. Democrats and Republicans on Capitol Hill agreed on the imperative to eliminate a previous cap on deductibles for small group policies sold on the exchanges — thereby giving businesses more options in the plans they offer.
The only thing on which they didn’t agree? Whether the legal revision was an “advancement” or a “repeal” of the ACA.