Alexander-Murray Exacerbates Flaw in ACA’s “Catastrophic Plans”

DPC physicians and patients take note!

An aspect of Alexander-Murray will exacerbate an under-appreciated flaw in ACA requirements for plans considered “catastrophic plans.”

Alexander-Murray will allow anyone to have a “catastrophic plan” as such plan is defined by ACA. ACA limits enrollment in these plans to enrollees under 30 years of age or enrollees who have a waiver. Alexander-Murray would do away with these limitations. So far so good.

Another ACA limitation on these plans — found in  ACA section 1302(e) — is that the plans will provide no benefits until the enrollee’s annual out of pocket limit has been reached, except that the plan must cover “at least 3 primary care visits.”

This will harmful to patients of DPC practices and is bad policy. It essentially forces primary care to be handled in-network — great for the insurance companies but not for the patients orthe doctors.

Ideally the requirement should be struck from ACA.  Alternately, a small change along the lines of this or something similar [in brackets] might help fix this problem:

(B)the plan provides—
(ii)coverage for at least three primary care visits, [unless the enrollee is separately contracted with a direct primary care physician, in which case the plan will refund to the enrollee an amount equal to the value of such coverage.]

Advertisements

The AMA is utter garbage. But, you knew that.

Here they go again. Once again the AMA is promoting what’s best for the big government / big insurance / big hospital cartel instead of advocating solutions that will truly empower patients, physicians, and increase access to high-quality, low-cost care.

How can we motivate Congress to act on ACA? End their illegal exemption!

From our friends at Independent Women’s Voice:

For the Senate to pass ObamaCare repeal and replace with only 51 votes, they’ll need to take action by September 30th.

How can we motivate Congress to act? By President Donald J. Trump ending Congress’ illegal exemption from ObamaCare.

Here’s what you need to do STAT:

  1. Sign the petition at www.NoWashingtonExemption.com
  2. Write President Trump and tell him to end the illegal exemption: https://www.whitehouse.gov/contact
  3. Read this explainer from Michael Cannon of CATO to become an expert on this crucial issue: http://www.washingtonexaminer.com/congress-illegal-and-egregious-obamacare-exemption-explained/article/2633383

The solution to healthcare is…

Most agree that we need a healthcare system that encourages people to take care of themselves and covers catastrophic injuries and disease for all people.

I trust the free-market more than government, and some trust the government more than the free market.

MACRA, ACA, HIPAA, HMO act, Medicare and Medicaid were supposed to reduce costs and expenditures. Obviously government only makes it all worse. Looks like a job for the freemarket!

Either way, whichever philosophical system is selected by the people, individuals must freedom of choice and bear their own responsibility to the extent that is humanly possible.

Craig M. Wax DO

CNBC reports:

Medical emergency: ER costs skyrocket, leaving patients in shock

  • Americans are being overcharged by more than $3 billion a year for ER services, according to data from Johns Hopkins School of Medicine.
  • Bills can be nearly 13 times the rates paid by Medicare for the same services.
  • Americans in the Southeast and Midwest, and poor and minority patients, are the most exploited by emergency-room billing practices, especially at for-profit hospitals.

Read full story:

https://www.cnbc.com/2017/08/10/medical-emergency-er-costs-skyrocket-leaving-patients-in-shock.html

The Ten Commandments of Healthcare

“Socialism is great until you run out of someone elses money.” ~Margaret Thatcher

Remember: Doctors for America was Doctors for Obama(partisan organization)

Read more: “Both Parties are Responsible for Healthcare Disaster” by Dr. Wax, published in Medical Economics, June 27, 2017 http://medicaleconomics.modernmedicine.com/medical-economics/news/both-political-parties-are-responsible-healthcare-disaster

VIDEO: Principles for Health Care Freedom

IP4PI founder Craig M. Wax, D.O. presents on Capitol Hill at the March 2017 meeting of the National Physicians’ Council for Healthcare Policy. Learn more about NPCHP efforts at http://npchcp.org. Read a synopsis of the principles here and view slides here.

 

Yet another failing report card for the “Affordable” Care Act

CMS released a county-level map of 2018 projected ACA Exchanges participation:

“This map shows that insurance options on the Exchanges continue to disappear.  Plan options are down from last year and, in some areas, Americans will have no coverage options on the Exchanges, based on the current data.”

“This is yet another failing report card for the Exchanges. The American people have fewer insurance choices and in some counties no choice at all. CMS is working with state departments of insurance and issuers to find ways to provide relief and help restore access to healthcare plans, but our actions are by no means a long-term solution to the problems we’re seeing with the Insurance Exchanges,” explains CMS Administrator Seema Verma.