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Bill Bateman
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Bill Bateman   My Press Releases

3 Obamacare Changes for 2017

Published on 7/26/2016
For additional information  Click Here

Boredom warning - this IS about health insurance in the USA…


OK - now that’s you’ve been warned...


I was reviewing a Kaiser Health News analysis of 3 changes coming to the Obamcare law in 2017 that will affect many of my under 65 year old readers in the US.


Like all things government is extraordinarily full of lawyer stuff. It’s in fact part of 530 pages of changes set for next year!


These changes are EXPECTED (not guaranteed) to be effective in 2017.


Change #1 - Network Provider Information & rules


Since the law passed, doctors have been leaving the networks because they are paid less through the exchange plans by law.


Under this new rule Insurance Companies will be required to give consumers a 30 day notice when a provider is being removed from a network.


Also, the insurance companies will be required to provide coverage for 90 days for those doctors that are removed from the network.


This is if a doctor is removed from a network.


If, however the doctor LEAVES the network on their own (which is what is happening) there is no such protection for the consumer and no consequence for the doctor.


Change #2 - Reduce “Surprise” bills for consumers for out-of-network services


When a consumer goes outside the network the provider charges what she wants not what the Obamacare schedule pays. This usually results in consumers being shocked with the amounts they have to pay that is not covered at all by their Obamacare coverage.


Under this rule change amounts paid by consumers for ancillary care - such as anesthesiology or radiology - will be required to count toward a patient’s annual out-of-pocket maximum. At that point (the point where someone reaches their out of pocket maximum) the INSURANCE company would be responsible for all in-network medical costs for the rest of the year.


However, the rule only applies in cases where the insurer has not given patients proper notice (generally 48 hours) that they might receive care and bills from such out-of-network providers.


So in reality it won’t affect many people at all.


Change #3 - Encourage “Standardized Plans”


Because of the way the law was written there are MANY variations by company of “Bronze - Silver and Gold” plans. Insurance companies had to comply with rules about the amount of claims they paid but didn’t have to have plans that were identical to all other insurance companies.


Under the final rule, the administration is requesting that next year (2017) insurers voluntarily offer plans with a standard set of coverage costs, such as standard deductibles and co-payments.


This way, the government believes, consumers will better understand the out-of-pocket costs associated with a plan.


As KHN notes, some state Marketplaces have already adopted standardized plans, however with this change being voluntary, and controversial with insurers, it may not have a large impact on consumers.


In conclusion


Government bureaucrats continue to try to “tweek” this law attempting to improve it. The consequence will be that fewer companies will participate and consumers choices will continue to decline while their costs continue to increase.


Bill Bateman - like Batman with an “E” in the middle I tell people


PS - if you want to have a doctor “on call” anytime you want to talk to one we’ve got that covered.

Take a look at this link and call me at 505-450-1574 if having access to a doctor on the phone 24/7 is something you like to know more about

Member Note: To comment on this PR, simply click reply on the owners main post below.
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