Seattle Children’s Hospital is taking legal action to correct a “false promise” of Obamacare. With only two out of the seven plans offered under Washington State’s health-care exchange covering treatment at the hospital, one of the state’s key providers of specialized pediatric care, it will sue the state’s insurance commissioner for “failure to ensure adequate network coverage.”
“The exclusion of a major provider like Seattle Children’s for a major insurance network in this market is unprecedented,” said Dr. Sandy Melzer.
For instance, CBS reported that four-year-old Kate Fink was denied coverage at the hospital for a ruptured eardrum because the plan her family purchased on the exchange didn’t include Seattle Children’s in its network. The insurance company originally authorized treatment for the girl at the hospital, but the family found out four days later the decision had been reversed because the hospital was out of network. Melzer said this was not an isolated incident.
“We’re seeing denials of care, disruptions in care. We’re seeing a great deal of confusion and, at times, anger and frustration on the part of these families who bought insurance thinking their children were going to be covered, and they’ve found that it’s a false promise,” he said.
For the time being, Seattle’s Children Hospital is paying for coverage for 200 families like the Finks, but those families may be on the hook for bills down the road.