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 More than 2 million people have signed up for new private health
plans that took effect on Wednesday under the Affordable Care Act,
popularly known as Obamacare. While some of those consumers were
already lining up doctor visits last month, early reports from
providers and an online medical booking service show the demand for
care has been modest so far.
Within the Obama administration, officials fear a surge of patients
in the coming weeks could spotlight cases where consumers who signed
up for insurance can't immediately get care due to technical
failures on the government's HealthCare.gov enrollment website.
Already on Friday, Senate Republicans opposed to the law seized on
scattered media reports of a handful of people having difficulty
confirming their new insurance policies, feeding into a narrative of
Obamacare's harms that is expected to intensify ahead of
Congressional elections in November.
Central Ohio Primary Care, a 250-physician practice, is holding off
on filing claims for patients who say they bought plans through the
HealthCare.gov exchange, said Chief Executive Officer Dr. William
Wulf.
The delay will allow insurers more time to confirm membership
information and avert any erroneous claim denials, Wulf said.
Such a grace period "surely is not desirable long term," he said,
but the number of patients with Obamacare plans has so far been low
and represents only a small fraction of the practice's patients.
"What we're doing is we're seeing the patients, trusting they are in
fact going to pay for insurance and just not sending a bill yet,"
Wulf said.
Contrary to fears that Obamacare enrollees would be sicker than
other Americans, with serious and expensive pent-up medical needs,
so far they are not much different from other Americans, according
to data from ZocDoc, a six-year-old closely held company that allows
patients to find a doctor who accepts their insurance and make an
appointment online.
Obamacare consumers "started booking appointments the last two weeks
of December for January appointments," said ZocDoc founder and Chief
Operating Officer Dr. Oliver Kharraz. "The vast majority of these
were for preventive care, not acute care where people indicated they
had an existing illness, which accounted for only 7 percent of
searches."
That mirrors the behavior of ZocDoc's previously insured users.
ZocDoc says the site gets just over 5 million unique visitors each
month who are searching doctors' ratings and reviews as well as
making appointments.
As many as 7 million people are expected to sign up for the new
health plans, which include government subsidies for lower-income
households, by the time 2014 enrollment ends on March 31. PENT-UP
DEMAND
Of course, some newly insured people were anxious to get care almost
as soon as the last strains of Auld Lang Syne petered out.
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One customer of North Shore-LIJ CareConnect, a new insurer selling
plans on the New York State of Health marketplace, went to its
customer center last month, paid cash for a policy, "and asked if he
could now schedule his son's gastric bypass," said Chief Executive
Officer Alan Murray.
In the case of another CareConnect customer, last month her doctor
arranged for her to have surgery for recently diagnosed endometrial
cancer as soon as possible. The insurer approved it in December,
before her coverage even kicked in, the surgery was successfully
performed on January 2, and the woman was discharged from the
hospital on Friday.
Insurers also heard from unusually high numbers of new customers
anxious to confirm their coverage.
On Jan. 1, Philadelphia-based Independence Blue Cross received
eight times as many calls as a typical New Year's Day from consumers
most commonly seeking to confirm that they were indeed covered, said
Brian Lobley, senior vice president of marketing and consumer
business.
"We haven't seen any systemic issues" of Independence's newest
members having trouble confirming their policies, he said.
Because medical practices often do not file insurance claims daily,
he added, it is too early to draw any conclusions about use of
medical services with the new plans.
On ZocDoc, people with Obamacare insurance searched most frequently
for primary care physicians, accounting for more than half of all
searches, said Kharraz, followed by obstetricians/gynecologists and
dermatologists. That is identical to the most-searched-for
categories for people with non-Obamacare coverage, he said.
Hospitals expect Obamacare to bring them more paying patients and
reduce the amount of uncompensated care they provide, but have not
seen a surge yet.
"We continue to expect an uptick in volume, but we don't think it's
anything beyond what most hospitals are prepared to handle," said
Jeff Goldman, vice president of coverage policy for the American
Hospital Association
Pharmacists are not reporting a surge in demand either. "At this
time, activity is fairly typical of what we experience each year
when insurance changes take effect," said Walgreen Co spokeswoman
Markeisha Marshall. "Nonetheless, we anticipate a surge of activity
next week."
(Editing by Michele Gershberg and Lisa Shumaker)
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