Administration Weighs Extending a Change to Health Law

The Wall Street Journal by Louise Radnofsky, Jared A. Favole and Jennifer Corbett Dooren –

January 31, 2014:

The Obama administration said Friday that it is considering ways to extend into 2015 efforts to prevent consumers whose health coverage changes from suddenly losing access to particular doctors.

President Barack Obama was told by a Kentucky woman in a Google Hangout on Friday afternoon that she was worried her 10-year-old son would not be able to continue to see his specialist if her new insurance plan does not include the physician in its network, and that she had been getting “wrong” and “conflicting” answers over several hours in phone conversations trying to resolve the issue.

Mr. Obama replied: “If you have a particular specialist and you haven’t found that specialist in the network of the exchange that’s offered in Kentucky, then we are looking at rules to make sure that somebody who’s actively being treated, for example, can remain with their specialist for the duration of their treatment.”

The Journal reported in late October that people trying to use HealthCare.gov to obtain new insurance were having trouble getting “provider lists” saying which doctors accepted which plans. Some of the lists also contained inaccurate or misleading information, doctors said. Those lists are especially important because many new health plans, in a bid to keep down costs, have narrower networks of doctors and hospitals than consumers are used to.

Federal officials announced in December that they were “strongly encouraging” insurers to continue covering at standard rates patients’ visits to doctors they had seen under their old policies, even if those doctors weren’t part of a new plan’s network.

The White House said after the president’s remarks on the Hangout that he had been referring to the steps that had already been announced, but that the administration was also considering options to renew the effort for next year.

The White House official said one option being weighed is whether health insurers’ procedures for letting patients stay with familiar providers, and the accuracy of their provider directories, should be a condition of selling coverage through the exchanges.