Friday, March 21, 2014

AMA Warns Obscure Obamacare Rule Could Hurt Doctors Financially

I have long warned that one of the dangers (among many) of Obamacare is the massive size of the regulatory document, itself. No one knows what all the details are in it and how they will impact individuals and different groups. Last year. I wrote:
As Carlyle Group founder and war profiteer David Rubinstein once told me about some legislation, "The devil is in the details."
Maybe this is what Nancy Pelosi meant when she said that Obamacare needs to be passed so that we can find out what is in it. 
The American Medical Association has just discovered that one detail buried in Obamacare may put physicians at serious financial risk. FOX News reports:
 The largest doctors group in the country is raising alarm that an obscure ObamaCare rule could stick them with the tab for patients who skip out on paying their premiums. 
The American Medical Association, which originally supported the Affordable Care Act, warned the rule could pose a "significant financial risk" for doctors and hospitals, and on Wednesday blasted out guidelines to help members try and avoid those costs.
At issue is a 90-day "grace period" which lets patients who are not paying their premiums keep coverage for 90 days before it can be canceled. 
Under the rule, insurers are responsible for paying any claims during the first month of that period -- but not necessarily for any claims during the final 60 days. 
"Managing risk is typically a role for insurers, but the grace period rule transfers two-thirds of that risk from the insurers to physicians and health care providers," AMA President Ardis Dee Hoven said in a statement.
The AMA is a very powerful lobbying group so they are likely to get the rule changed, but this is just one example of how individual clauses in Obamacare and other government regulations can have serious impact on sectors of the economy. This, of course, is far, far away from the free enterprise system and the non-aggression principle.


  1. What is to prevent individuals (or entire families for that matter) from continually enrolling, being dropped for non-payment of premiums, re-enrolling, getting dropped, rinse, repeat?

    If my understanding is correct, they will be effectively in a state of continuous coverage, and never pay a premium. Would this state of coverage preclude any penalties for non-coverage?

    Also, what about those who pay their premiums, but nothing else? I can guarantee there is a large swath of new enrollees who have no concept of what 'deductible' or 'copay' means. They will think that the premium is all they have to pay...

  2. I have a lady friend who is getting a subsidized ACA plan. Her premiums are near $250 each month. Her deductible and co-insurance for a major accident/illness will be $6350. Per this story, hospitals and physicians want to be paid--deductible up front and co-insurance as you go. How many people getting a health insurance premium subsidy can write a check for $6000 dollars? Answer: ZERO!