The number of physicians nationwide that are declining to accept health plans from Obamacare exchanges is growing, according to a study from the American Action Forum.
As of May 2014, over 214,000 doctors wouldn’t participate in Obamacare plans, and that number may be growing, according to AAF, a free-market think tank in Washington. While some Obamacare kinks have been worked out over the past year, exchange plans remain as unfriendly to doctors as ever.
Obamacare puts physicians — especially the dwindling number of those in private practice — in an especially difficult financial situation, expecting doctors to eat the costs of patients who discontinue coverage and to simply take on more patients to make up for bottom-level reimbursements.
Exchange plans nationwide pay on average significantly less than plans in the private market and even Medicare, according to AAF. While private plans generally pay doctors $1.00 for performing a given service, Medicare averages just $0.80; exchange plans are allowing doctors just $0.60 for the same thing. That puts Obamacare plans more in line with Medicaid reimbursements, AAF reports, and Medicaid’s low reimbursement rates have been driving doctors away for years. (RELATED: Study: Doctors Say No To Medicaid)
The low physician reimbursements are likely borne out of the administration’s strong-handed push to keep Obamacare premium hikes as low as possible. In order to keep price low, insurers have to cut costs somewhere; in exchanges, companies moved to covering just narrow networks with few in-network physicians and offering low reimbursement rates to doctors with the promise that if physicians work even more, they’ll recoup their losses.
But the structure of the Affordable Care Act itself puts doctors who accept plans purchased on Obamacare exchanges at risk of never being paid at all. Obamacare requires insurers who sell plans on the exchanges to keep coverage active even after a customer has stopped paying their premiums, for an extra 90 days.
For the first 60 days after a customer has stopped paying but is still insured, the insurance company has to pay for any care the patient uses. But for any services used in the final 30 days before a customer’s insurance can be terminated, doctors that see those patients won’t be paid at all.
It’s no wonder that in such an unfriendly climate for physicians, many are staying out of Obamacare plans. At the beginning of Obamacare’s first enrollment period last year, over 70 percent of California’s physicians weren’t participating in Covered California plans, according to AAF — a big problem for the state with the largest Obamacare enrollment in the nation.
That number has grown to over 200,000 physicians nationwide as of May, before the open enrollment period ended and before insurance was active for many customers. Doctors that took losses from their participation in Obamacare plans may be even more skittish about accepting exchange coverage this year. (RELATED: Doctors Begin To Refuse Obamacare Patients)