The Corner

Doctor Rationing Coming to California Soon

Over at Bloomberg View, Lanhee Chen, a fellow at the Hoover Institution at Stanford University, reports more bad health-care news coming out of California: The implementation of Obamacare will soon trigger doctor rationing. He writes:

The Los Angeles Times reported yesterday that Californians will actually be paying more for less because of the “Affordable” Care Act. From the article:

“The doctor can’t see you now.

Consumers may hear that a lot more often after getting health insurance under President Obama’s Affordable Care Act.

To hold down premiums, major insurers in California have sharply limited the number of doctors and hospitals available to patients in the state’s new health insurance market opening Oct. 1.”

While this piece of news can’t be helpful to the White House’s effort to sell Obamacare, it shouldn’t come as a surprise to anyone who has been following the troubled implementation of the health-care law.

This isn’t surprising. The law requires insurance companies to live under a very rigid and burdensome new regulatory regime where they have to provide affordable (whatever that means in this case) insurance plans for all, regardless of preexisting conditions or age. However, as is starting to be obvious, in many states insurers will increase premiums on younger and healthier Americans to pay for the extra cost generated by older and sicker ones. California is no exception. In addition, insurers in high-profile states are facing significant political pressure to keep premiums as low as possible, leaving them with little choice but “to restrict access to certain care providers — limiting patients’ ability to choose specific doctors or hospitals, lengthening wait times or forcing them to see a new doctor because their current one isn’t part of an insurer’s provider network.” He explains:

This is exactly what will happen in California come 2014, when the state’s Obamacare exchange is launched. Physicians and physician organizations in California have expressed concerns that these limited provider networks may most adversely impact minority communities, the very ones that the health-care law purports to help most. Those concerns reflect the fact that while some coverage is better than none at all, Obamacare’s supporters have dramatically oversold the supposed benefits of the law.

For example, the Times reported that the insurer expected to offer the best prices on California’s health-insurance exchange next year is Health Net. But enrollees in its plans will have access to just 2,316 physicians in Los Angeles County. That’s one-quarter of the physicians available to enrollees in an Anthem Blue Cross plan, and less than half of the doctors available to enrollees in Kaiser Permanente’s exchange-qualified plans. Cheaper plans with limited networks and access to fewer providers should be options for consumers, but Obamacare is effectively forcing low-income Californians into this kind of coverage.

And what of others who might voluntarily choose plans with limited provider networks? California’s health exchange regulator has suggested — in a stroke of unwelcome paternalism –that it reserves the right to drive out health plans that fail to provide sufficiently expansive networks of providers. This kind of heavy-handed regulatory activity undercuts the contention that Obamacare will expand options for consumers looking for affordable health-care coverage.

Of course, whether it is rationing of doctors or higher premiums or both, this outcome won’t be restricted to California. As such, it is no surprise that Obamacare is becoming increasingly unpopular.

For more Obamacare bad news in California go here and here.

Veronique de Rugy is a senior research fellow at the Mercatus Center at George Mason University.

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