We Don’t Take Obamacare

In a recent New York Times article titled “Sorry, We Don’t Take Obamacare”, Elisabeth Rosenthal highlighted some of the growing pains of the new system.  In particular, insurance companies are learning to craft plans with narrow networks that restrict access a patient’s to physicians. However, there are other reasons why those who are covered though the ACA cannot see the doctor of their choice. Unfortunately, the reasons have less to do with the complexities of health insurance coverage, and more to do with ideology and spite.

obamacare.jpgOne of the primary goals of the Affordable Care Act was to reduce the number of uninsured Americans, and by that measure the law is a great success. The uninsured rate hit a recent peak at the end of 2014, with 18% of the population lacking healthcare coverage. Today the uninsured rate has fallen to 9.1%.  This achievement is still viewed negatively, or is disregarded entirely by many people who have not experiences the difficulties in obtaining healthcare coverage when it is not handed to you by your employer.

My Obamacare story goes like this: As a self-employed contractor since 2002, I was required to seek healthcare coverage for me and my family through the individual market. I started out paying roughly $1300 a month to cover myself, my spouse, and two small children. It was a significant but necessary expense. I selected a basic HMO plan covering only in-network care, and it was near the limit of what I could afford that met our needs as a family.

Each year I saw my premiums rise by fifteen, twenty percent, or more. When my monthly premium hit $2000 a month I could no longer keep up. I cut back to the cheapest HMO plan with the highest deductibles, coinsurance, the highest everything I could get. That lowered it back to about $1300, but my out-of-pocket expenses were now much higher.

The Affordable Care Act was a great relief for me. As soon as the site opened, I was able to find an HMO plan that was better than the first one I got in 2002, yet the monthly premium was less expensive, under $1300 a month. The rates actually went down for the next two years. It was wonderful.

In early 2015 I had a medical procedure performed by a specialist here in Sussex County. When it was done, the doctor asked that I return later in the year for a follow-up. About six months later, I called the office to schedule that treatment. I couldn’t believe what I was told.

The office administrator asked for my healthcare plan. I gave her my insurance provider’s name for the plan. She abruptly told me: “That’s an O-BAHHHHH-ma Care plan! We don’t take O-BAHHHHH-ma Care! The disdain in her voice was nauseating. I explained that my insurance plan had not changed since I saw the doctor earlier in the year, and that I was just following up on the doctor’s advice to come back for a second treatment. I had already been treated by that doctor under this plan.  But each time I offered anything to this person, all I heard from the other end was “We don’t take O-BAHHHHH-ma Care!"

Eventually, I hung up and found a different doctor.

After my follow-up treatment, I told this story to the other physician. He shook his head, and explained that my original doctor is very active politically in the local physician association.

In other words, he suffers from Obama derangement syndrome.

I understand that politics has turned into a team sport; my team wins, and your team loses. I expect that from the average person on the street. I don’t expect it, and won’t tolerate it, from a physician when it comes to my health. Ideology and spite have no place in a doctor’s office.

[Written by an SCDC Contributor.]