Take time to read Elizabeth Rosenthal’s latest installment of her “Paying Till it Hurts” series in The New York Times: Insured, but not Covered.
If you are like many Americans struggling with high-deductible, narrow-network health plans, you might relate to the families she writes about.
The Affordable Care Act has ushered in an era of complex new health insurance products featuring legions of out-of-pocket coinsurance fees, high deductibles and narrow provider networks. Though commercial insurers had already begun to shift toward such policies, the health care law gave them added legitimacy and has vastly accelerated the trend, experts say.
The theory behind the policies is that patients should bear more financial risk so they will be more conscious and cautious about health care spending. But some experts say the new policies have also left many Americans scrambling to track expenses from a multitude of sources — such as separate deductibles for network and non-network care, or payments for drugs on an insurer’s ever-changing list of drugs that require high co-pays or are not covered at all.
For others, the constant changes in policy guidelines — annual shifts in what’s covered and what’s not, monthly shifts in which doctors are in and out of network — can produce surprise bills for services they assumed would be covered. For still others, the new fees are so confusing and unsupportable that they just avoid seeing doctors.
Unfortunately, while the story is informative and perhaps offers solidarity in suffering or fore warning of insurance pitfalls, there is no indication that the problems outlined will be going away any time soon.
But by endorsing and expanding the complex new policies promoted by the health care industry, the law may in some ways be undermining its signature promise: health care that is accessible and affordable for all.
…for now, patients are most often left to fend for themselves.
One patient aptly described her situation as “insurance purgatory.”
- Alternatives to Obamacare
- Lack of transparency keeps medical costs high
- Patients being nickel and dimed