The California Medical Association (CMA), the State’s largest physician’s organization, estimates that 70 percent of doctors won’t participate in Covered California, the State’s Obamacare health insurance exchange.
That prediction comes after the CMA reviewed Obamacare coverage forecasts provided by independent insurance brokers, even though Covered California is touting an expected 85 percent doctor participation rate.
CMA’s vice president of medical and regulatory policy, Lisa Folberg, told the Washington Examiner that Covered California comes by its 85 percent participation figure through some optimistic statistical legerdemain.
“Some physicians have been put in the network and they were included basically without their permission,” she said.
That’s because Covered California is using a pre-deployment document released in May that came out before doctors had a chance to respond to a memo of understanding with Obamacare insurers. The doctors’ reticence then was understandable – they hadn’t seen a rate schedule, so they had no idea what kind of compensation they were being asked to accept.
“Only in September did insurance companies disclose that their rates would be pegged to California’s Medicaid plan, called Medi-Cal,” reports the Examiner’s Richard Pollock. “That’s driven many doctors to just say no.”
Alameda County Health Care Services Agency director Alex Briscoe said he’s not shocked that doctors aren’t lining up to take a pay cut under Obamacare.
From the report:
“Enrollment doesn’t mean access, because there aren’t enough doctors to take the low rates of Medicaid,” [Briscoe] said. “There aren’t enough primary care physicians, period.”
Briscoe hopes his eight community health centers can handle the 200,000 uninsured individuals he said reside in his county, but he warned that “there is a doctor shortage. It is going to get worse as more people enter the market.”
Briscoe professed not to be surprised by the refusal of doctors to participate in Covered California. “It rings true. I’ve been kind of wondering in my head, ‘How are they offering such low premiums?’”
In addition to low doctor participation, Obamacare is compounding the access problem by incentivizing another way for doctors to opt out: retirement.
“I just turned 55, and a lot of us are kind of going, ‘Maybe there’s something else we can do in the last 10 years,’ because this is just getting too onerous to keep on going,” San Diego ENT specialist Theodore M. Mazer told the Examiner.