Categories

This Examiner article highlights how unpopular California’s health insurance exchange is:

An estimated seven out of every 10 physicians in deep-blue California are rebelling against the state’s Obamacare health insurance exchange and won’t participate, the head of the state’s largest medical association said.

Here’s why they’re rejecting California’s exchange:

California offers one of the lowest government reimbursement rates in the country, 30 percent lower than federal Medicare payments. And reimbursement rates for some procedures are even lower. In other states, Medicare pays doctors $76 for return-office visits. But in California, Medi-Cal’s reimbursement is $24, according to Dr. Theodore M. Mazer, a San Diego ear, nose and throat doctor.

In other states, doctors receive between $500 to $700 to perform a tonsillectomy. In California, they get $160, Mazer added.

Only in September did insurance companies disclose that their rates would be pegged to California’s Medicaid plan, called Medi-Cal. That’s driven many doctors to just say no.

Something significant is happening. California’s exchange is creating a network of physicians and specialists who won’t participate in the exchange. Eventually, California’s laws will have to change because these exchanges can’t work without doctors, which is already happening.

Further, Medi-Cal’s re-imbursement rates need to improve. Unfortunately, California’s financial situation, putting it charitably, is a basket case. There’s little question that Medi-Cal is giving Californians another excuse to abandon California. This information is disturbing:

They’re also pointing out that Covered California’s website lists many doctors as participants when they aren’t. “Some physicians have been put in the network and they were included basically without their permission,” Lisa Folberg said. She is a CMA’s vice president of medical and regulatory Policy. “They may be listed as actually participating, but not of their own volition,” said Donald Waters, executive director of the Alameda-Contra Costa Medical Association.

Waters’ group represents 3,100 doctors in the East Bay area that includes Oakland, with an estimated 200,000 uninsured individuals.

“This is a dirty little secret that is not really talked about as they promote Covered California,” Waters said. He called the exchange’s doctors list a “shell game” because “the vast majority” of his doctors are not participating.

Why is this exchange listing doctors as participating in the exchange when they aren’t? I’ll speculate that it’s done intentionally because the exchange can’t admit that it’s a failure. Admitting that 70% of doctors aren’t participating in the exchange would demolish the exchange’s credibility.

Technorati: , , , , , , ,

One Response to “California doctors rejecting California’s HIX”

  • walter hanson says:

    Gary to sum it up, “the government can say you have health insurance now, but good luck finding a doctor or hospital for that insurance.”

    Walter Hanson
    Minneapolis, MN

Leave a Reply