Grace Periods, Shrinking Networks And The WBC

The American Medical Association is discovering that it ought to have read the fine print a bit more carefully to the health care law they were instrumental in lobbying for.

Four years after passage, the country’s largest physician’s group is cautioning that a provision under Obamacare could leave doctor’s eating the cost of the services they provide patients should said patients stop paying their insurance premiums.

Under the “grace period”  provision, patients are allowed to maintain their coverage for up to 90 days before being dropped should they fail to pay their premiums. While the rule states that insurers are responsible for paying claims in the first 30 days, that doesn’t necessarily continue for the next sixty, opening up physicians and other primary providers to “significant financial risk”. Says AMA President Ardis Dee Hoven:

“Managing risk is typically a role for insurers, but the grace period rule transfers two-thirds of that risk from the insurers to physicians and health care providers”.

While the AMA has hastily issued guidelines to members in an attempt to blunt such risk, they’ve also been courting the Obama administration to alter the rule, asking that insurers be required to inform providers and hospitals should patients fall behind on payments. All things considered, this is a good maneuver. After all, the administration has certainly demonstrated a proclivity for changing the rules midstream. Why stop now?

In the meantime, doctor’s were supposed to the harbingers of preventative measures, right? Given that the AMA lobbied so intensely for Obamacare’s passage, why didn’t they bother to look closer for any potential burdens on the physicians they advocate for? It’s certainly easier to mitigate such risk before the law is implemented than after, no?

Nancy Pelosi’s oft-mocked aphorism “you gotta pass it to find what’s in it” strikes again, apparently.

~ While physicians face the possibility of picking up their patient’s hefty tabs, would-be patients themselves are finding it difficult to see doctors in the first place.

Those selecting plans on the federal exchanges are finding that gaining access to the doctors or hospitals of their choosing isn’t all that easy. Hospitals aren’t participating, doctors aren’t accepting their coverage, or both.

That’s not an accident, but a feature, of Obamacare. The best way to keep premiums affordable for the lower-tier bronze or silver plans is to limit the size of doctor and hospital networks, leaving out the highest priced or specialized providers.

According to McKinsey, while insurance carriers in the 20 cities nationwide that they analysed have increased the number of available policies, 68% of those options have limited networks, thereby limiting patient choice or even forcing patients to find new doctors, finding that their previous doctor or hospital of choice is no longer in network.

You can read much more at the linked article, but a few quick thoughts: What exactly is the point of having coverage if you increasing can’t get care? Or are increasingly inconvenienced before you finally get it? Wasn’t Obamacare supposed to ameliorate those problems? Is government creating problems with Obamacare, hoping simultaneously to solve them with Obamacare?

Given that they can’t even get the post office right, I fear for the state of American health care once the Obama administration decides to fully implement their own law just as it was passed.

~Finally, word came today that Fred Phelps, founder of the fantastically controversial, anti-gay, anti-military, anti-just-about-everything Westboro Baptist Church, has died. I’m not going to spend too much time on such a perpetually toxic personality such as him and his ilk, except for a couple things.

In a statement released by the “church” today addressing rumors that Phelps had previously been expelled from the congregation, they stated:

“Listen carefully; there are no power struggles in the Westboro Baptist Church, and there is no human intercessor — we serve no man, and no hierarchy, only the Lord Jesus Christ.”

Phelps himself stated earlier:

“If I had nobody mad at me, what right would I have to claim that I was preaching the Gospel?”

I don’t claim to be intimately familiar with all of the Bible. I am conversant, however, with what Jesus said about those claiming to “love” Him or wishing to adhere to his Gospel message: “follow my commandments”. The entirety of the Gospel can be, quite simply, boiled down to two such commands, made without equivocation or pre-condition: love God, and love your neighbor as yourself.

WBC gained their notoriety from signs that included “God hates fags”. This is an abuse of both of Christ’s commands. Obviously, this is no loving sentiment towards a neighbor, but is also a bald insult to God himself, who far from “hating” anyone, instead offered up His son, not to condemn the world, but that through Him the world might be saved.

This includes even men like Fred Phelps. There’s only salvation or condemnation. My personal sense is that he’s received exactly what he deserves. Not according to our sense of justice, but God’s Himself. And in that, I’m well satisfied.






About Michael Haugen

Michael Haugen is a full-spectrum conservative and recent graduate from Eastern Washington University (BS Biology). His main interests in politics and public policy center around health care, education and tax reform. He'll be returning to EWU in 2014 to complete a Master's degree in Public Administration. Follow him on Twitter: @HaugenTRA

One Response to “Grace Periods, Shrinking Networks And The WBC”

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