The numbers are in: after numerous extensions, exemptions, and delays, about two million people signed up for insurance in state and federal exchanges by the December 24th deadline. Though the law was passed largely to extend insurance to the forty-eight million uninsured Americans, that two million isn’t only people who were previously uninsured—it also includes people who had to get new plans after the ACA forced insurers to cancel their plans. But even with that cancelled coverage inflating the numbers, the exchanges still netted one million less than the three million Obama administration predicted.What kind of health care experience will those two million people have? The WSJ reports that people who bought new insurance on the exchange are flocking to providers to make use of their old coverage before it expires. The new plans are often more restrictive than the old ones—in some cases much more restrictive—and patients are trying to use providers that their new plans won’t cover while they still can:
UT Southwestern Medical Center in Dallas has seen requests for complicated imaging tests and colonoscopies rise in recent weeks, said Bruce Meyer, an executive vice president. Barnes-Jewish Hospital in St. Louis has seen “dozens” of patients push up elective orthopedic surgeries, a spokeswoman said. Cedars-Sinai Health System, a top teaching hospital excluded from most exchange plans in the Los Angeles market, said it has fielded thousands of calls from people concerned about losing access and wanting to schedule elective procedures before Dec. 31.
The article points out these restrictions could save consumers money in the same way the HMO movement did in the 1990s, but provider restrictions are likely to be just as unpopular now as they are then—especially for people who were forced off of plans that gave them access to providers they liked. Whatever you think about the benefits of networks restrictions generally in lowering costs, the particular way the ACA is pushing people into smaller networks will ensure that the law will continue getting bad press far into the future, fixed website or not.