Monday, December 21, 2015

Truest statement of the week II

While premiums and deductibles continue to rise, the plans offered are steadily deteriorating in quality. The Robert Wood Johnson Foundation reported last month that PPOs, which provide health insurance that pays for both in-network and out-of-network health providers, are dwindling as an option on the Obamacare exchanges.
People shopping for insurance in the ACA “marketplace” are increasingly finding the offerings limited to health maintenance organizations (HMOs) and exclusive-provider organizations, both of which provide extremely limited coverage when patients want to visit an out-of-network health care provider.
The availability of PPOs on the exchange is expected to fall by 41 percent between 2015 and 2016. As of this year in New York City, no PPOs were offered either through Obamacare or on a private insurance exchange, but were available only through employer-provided coverage.
For a patient suffering from a debilitating disease, restriction to an HMO likely means he will no longer be able to visit a specialist, such as an oncologist or rheumatologist, with whom he has established a relationship over months or years. The impact is potentially life-threatening.

-- Kate Randall, "Obamacare enrollment deadline: Fines mount for failure to buy costly, barebones insurance" (WSWS).

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