The Campaign Spot

Obamacare’s Bad News Didn’t Stop; The Media Just Lost Interest

Several news cycles pass without much discussion of Obamacare/the Affordable Care Act. Some may interpret this as a sign that disapproval of the law is wavering — it isn’t — or that the reports of frustration, waste, mismanagement and premium hikes have stopped. They haven’t stopped, they’re just not surprising news anymore, and they’ve been pushed to the back pages by the summer’s cavalcade of crises: the humanitarian crisis on the border, ISIS taking over Iraq, Russian separatists shooting down airliners, Israel fighting Hamas, and so on. As mentioned in today’s Jolt

Just Because You’re Not Hearing About Obamacare Messes Doesn’t Mean Obamacare Isn’t Making New Messes (or Exacerbating Old Ones)

Hey, remember Obamacare?

The New York Times checks in with those who have insurance for the first time:

Last week, Salwa Shabazz arrived at the office of a public health network here with a bag full of paperwork about her new health insurance — and an unhappy look on her face. She had chosen her plan by phone in March, speaking to a customer service representative at the federal insurance marketplace. Now she had problems and questions, so many questions.

“I’ve had one doctor appointment since I got this insurance, and I had to pay $60,” Ms. Shabazz told Daniel Flynn, a counselor with the health network, the Health Federation of Philadelphia. “I don’t have $60.”

Mr. Flynn spent almost two hours going over her Independence Blue Cross plan, which he explained had a “very complicated” network that grouped doctors and hospitals into three tiers. Ms. Shabazz, who has epilepsy, had not understood when she chose the plan that her doctors were in the most expensive tier.

Another survey indicating that a significant chunk of the uninsured aren’t paying any attention to anything:

Among those who were uninsured last year and remain uninsured, only 59% were familiar with the new Obamacare marketplaces and 38% were aware of federal subsidies to lower their insurance costs, according to the survey conducted in June by the nonpartisan Urban Institute.

About 60% of respondents list cost as the main reason for not having insurance. But 20% say they don’t want health insurance or would rather pay the fine for not having coverage.

The price tag just keeps growing, well beyond previous estimates: “Between September 2011 and February 2014, the “federally facilitated marketplace” (FFM) saw costs grow from $56 million to $209 million. Meanwhile, the costs for the related data hubs, the so-called ‘back office operations,’ rose from $30 million to $85 million.”

Up in Massachusetts, the folks who failed to gets the state’s health-insurance exchange running smoothly on time . . . are getting a bunch of raises.

Recently, Massachusetts Health Connector executive director Jean Yang doled out raises of $10,000 or more to 11 of the agency’s 53 workers. The increases ranged from 15 percent to 24 percent, with another 3 percent on the way in the fiscal 2015 budget if the agency meets goals to successfully re-launch its balky website by November.

Yang said the salary increases are needed to retain valued employees and improve performance going forward. This action comes after the embarrassing debacle associated with the state’s rollout of its Obamacare website, which has cost taxpayers nearly $1 million in computer fixes and lawsuits and still isn’t resolved.

Yang is also planning to hire eight more workers, increasing the staff to 61.

The last time we saw Yang she was tearfully testifying on Beacon Hill about the website’s failures. The strain on her staff, and the demoralizing effects it had on them, were articulated quite extensively.

Indeed, failure is demoralizing. Speaking of Massachusetts, you may have missed this Friday:

Former Rep. Barney Frank (D-Mass.) slammed the administration’s ObamaCare rollout, calling President Obama’s claim that people could keep their insurance plans under the law a “lie.”

“The rollout was so bad, and I was appalled — I don’t understand how the president could have sat there and not been checking on that on a weekly basis,” Frank said in an interview with the Huffington Post published Friday.

“But frankly, he should never have said as much as he did, that if you like your current health care plan, you can keep it,” he continued. “That wasn’t true. And you shouldn’t lie to people. And they just lied to people.”

Here’s a story of Hartford, Connecticut doctors facing reality on the reimbursement rates:

On a recent afternoon at his office in Hartford, Conn., Dr. Doug Gerard examines a patient complaining of joint pain. He checks her out, asks her a few questions about her symptoms and then orders a few tests before sending her on her way.

For a typical quick visit like this, Gerard could get reimbursed $100 or more from a private insurer. For the same visit, Medicare pays less — about $80. And now, with the new private plans under the Affordable Care Act, Gerard says he would get something in between, but closer to the lower Medicare rates.

That’s not something he’s willing to put up with.

“I cannot accept a plan [in which] potentially commercial-type reimbursement rates were now going to be reimbursed at Medicare rates. You have to maintain a certain mix in private practice between the low reimbursers and the high reimbursers to be able to keep the lights on,” he says.

Three insurers offered plans on Connecticut’s ACA marketplace in 2014 and Gerard is only accepting one. He won’t say which, but he will say it pays the highest rate.

“I don’t think most physicians know what they’re being reimbursed,” he says. “Only when they start seeing some of those rates come through will they realize how low the rates are they agreed to.”

Gerard’s decision to reject two plans is something officials in Connecticut are concerned about. If reimbursement rates to doctors stays low in Obamacare plans, more doctors could reject those plans. And that could mean that people will get access to insurance, but they may not get access to a lot of doctors.

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