Rate Shock seques into “Provider Shock”

New “glitch”: If you like your hospital, you might not be able to keep your hospital « Hot Air.

Turns out you can’t expand coverage, cap patient costs, and expect providers to work for less, just like you can’t create the conditions for a major adverse selection problem and expect insurers to flood into the new market. “Some hospitals and doctors don’t even know if they are in the network,” says one expert, a point also made in the WSJ story I flagged this morning about consumers often having no idea who’ the providers are in each plan offered on the state exchanges.

I spoke with a client today and her daughter is in the process of being diagnosed for a blood disorder under the care of Children’s Hospital in Aurora, CO. Shopping on the Colorado Marketplace, Connect for Health Colorado, the number of available plans shrinks from 78 to 13 if Children’s Hospital is required to be in-network.

An additional complication is the client is planning to move in July to another State. If she takes ANY Marketplace plan, she will have to get a new plan with a new deductible in the middle of the year.

Fortunately, there’s a solution with an off the marketplace insurer that will allow her to “keep her plan” when she moves. Well, that’s a helluva lot better then Obama can do.



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