If you are self-employed like me, you've watched year after year as your health insurance premiums have risen and wait with bated breath to see if your carrier is going to drop you for some nitpicky or made-up reason. The passage of the Affordable Care Act (or "ObamaCare" as many call it) promised to curtail out-of- control premiums while making pre-existing conditions and unreasonable terminations a thing of the past.
It's been 2 weeks since the ObamaCare insurance exchange was launched and, so far, most of the feedback has been directed toward how difficult the websites are to use. Not much has been written about what's on the menu in terms of policy offerings.
The truth is that the Affordable Care Act will have little effect on the vast majority of Americans because they get their health insurance through their employers. Only the self-employed or unemployed really care about the substance of the program (in other words, the non-political issues).
Since California's ObamaCare website is now up and running, https://www.coveredca.com/, I jumped on to see if I can do better than my grandfathered Kaiser plan. While I don't qualify for a subsidy, I like the idea of being able to choose a plan that would allow me to see non-Kaiser specialists without having to fight for the privilege.
Well, there is good news and very bad news. The good news is that the premiums, deductibles and out-of-pocket maximums for Blue Cross Anthem and Blue Shield really do seem to be not much higher than when I've shopped for individual insurance in the past.
The bad news? If you choose one of Covered California plans, you can only use providers in a very, very limited network. These networks are definitely not as broad as you'll find in employer policies or even in the current self-employed policies. However, the truly troubling thing is that both of these reputable insurers have eliminated top providers for the Covered California plans. Rumor has it that Cedars Sinai is in nobody's network while UCLA is only allowed by Anthem (and possibly not all of Anthem's offerings).
I can't really tell you much more than this because the part of Covered California's website that shows which doctors and facilities participate in which plans is still broken. And the Anthem and Blue Shield websites don't give the info either. In fact, I uncovered the information about reduced number of providers and lack of Cedars and UCLA by accident when Googling about ObamaCare. A call to Covered California was a complete waste as the rep, while extremely nice, did not have access to any info that I couldn't find elsewhere. He also didn't know when the provider directory would be available.
My hope is that Blue Shield and Anthem will continue to offer more traditional individual plans that include Cedars and UCLA, even if they cost more. I'd much rather forgo "affordable" care if it means I'll still have access to top care when I need it.
Millie Cavanaugh is a solo attorney practicing immigration law in Culver City and the Los Angeles area.
