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Obamacare Signature Achievement SC

Yet another calculated ObamaCare assault on healthcare providers has been ferreted out of the 2700 impenetrable pages (plus revisions) of Barack Obama’s signature achievement.

Doctors and hospitals nationwide can already expect to be paid a pittance for their services to ObamaCare patients. And now, yet another financial blow to providers has been discovered.

“The Affordable Care Act created a 90-day grace period before insurers can drop policy holders who fall behind on premiums. So, delinquents who obtain tax-subsidized health insurance through an Obamacare health insurance exchange have three months to settle up their bills prior to their policy being canceled.” (1)

In short, if you are among the ObamaCare enrollees who receive a subsidy from the Federal Government, you are awarded a 90 day grace period before your insurance company can cancel your policy for non-payment. It’s a rule that applies to anyone who secures their subsidized coverage through an ObamaCare exchange.

This provision, as originally written into the Affordable Care Act, would have forced insurance companies to pay 90 days worth of claims to doctors, hospitals, and other healthcare providers, even though their insureds had not paid a penny toward their policy premiums during that period. Needless to say, insurance companies were not about to swallow such a bitter pill. And Barack NEEDS the support of insurance providers if ObamaCare is to have any chance of survival.

So in March of this year, the Centers for Medicare and Medicaid Services (CMS) decided to unilaterally change the Affordable Care Act, a la Barack the First. It is now the rule that insurance companies must pay claims through the first 30 days of delinquency. BUT, from the 31st until the 90th day of non-payment, insurance companies will no longer be responsible for the payment of claims. For this 2 month period, it will be up to doctors, hospitals, and any other healthcare provider to collect fees for their services directly from patients!

Therefore, if the holder of a subsidized, ObamaCare policy owes a hosptital $55,000, and assorted doctors another $20,000, it will be up to those providers to collect directly from that patient! You know…the same patient who could not or would not pay Anthem Blue Cross/Blue Shield, for example, a $347 monthly premium!

Can healthcare providers protect their interests by inquiring of insurance companies whether Jimmy Jones is current with his premiums? Why, of course! In fact, CMS wrote into its new, March rule that “[Obamacare] exchanges’ health plans ‘should notify all potentially affected providers as soon as practicable when an enrollee enters the grace period.’” (My emphasis) “Should notify…as soon as practicable?” What in the world does THAT mean? In July, Medical Group Management Association-American College of Medical Practice Executives (MGMA-ACMPE) CEO Susan Turney wrote to the CMS, correctly pointing out that “…providers should be notified as soon as the grace period begins, otherwise ‘it will be too late for physicians to engage patients and make informed decisions prior to furnishing potentially uncovered services.’”  (My emphasis)

Will the CMS accede to the demands of Turney and healthcare providers nationwide? Not if Barack and the leftist authors of ObamaCare want to maintain a positive reputation for their Marxist plan with current and future purchasers. After all, should thousands of ObamaCare enrollees suddenly be informed that expected surgeries will NOT be performed, their response will resemble the wailing of a chorus of scorched cats! And we can bet that a media presentation of such stories will be put in terms of: “Disadvantaged patients of color refused life-saving treatment by greedy hospitals and physicians!” The fact that these patients haven’t paid their premiums is unlikely to be mentioned, never mind emphasized.

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The views expressed in this opinion article are solely those of their author and are not necessarily either shared or endorsed by WesternJournalism.com.

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