“Those who do get coverage through the exchanges and pay their premiums will also struggle to get medical care. The ACA requires insurers to accept every patient regardless of risk, provide expansive benefits packages, and eliminate caps on lifetime benefits. Looking to control costs, most insurers are offering exchange plans that severely limit the number of doctors and hospitals patients can visit. Some state exchanges—including New York’s—don’t offer a single plan that covers visits to out-of-network doctors or hospitals. Many people will not be able to see the physicians who have treated them for years, use facilities providing the most appropriate treatment, or access care within a reasonable time and distance from their homes. Some specialty hospitals have been excluded from all exchange plans.” “Worst of all, insurance coverage under the ACA is unlikely to improve health outcomes. The much-noted Oregon Medicaid-expansion study found that new Medicaid enrollees showed no improvement in health outcomes compared with the uninsured. Other studies have shown that Medicaid patients have worse outcomes compared with privately insured patients (though why this happens is not well understood). The health outcomes of many exchange patients will suffer as a result of not being able to see their regular physicians or access the most appropriate specialists and hospitals.
* to read the full City Journal article “The Doctor Won’t See You Now” by Joel Zinberg highlight and click on open hyperlink http://www.city-journal.org/2014/eon0414jz.html