New Obamacare weapon for GOP: Doctors
By: Seung Min Kim and Jennifer Haberkorn
December 3, 2013 06:24 PM EST
Get ready for the next line of attack from the GOP on Obamacare: good luck keeping your doctor.
As other controversies surrounding the law begin to fade, House Republicans are increasingly focused on President Barack Obama’s pledge that “if you like your doctor, you will be able to keep your doctor.” They’re hoping to replicate the uproar over canceled insurance plans, which has caused problems for millions of consumers nationwide and political headaches for Democrats.
Speaker John Boehner (R-Ohio) said to reporters on Tuesday that the “fundamentally flawed” health care law is “causing people to lose the doctor of their choice.” Chief GOP investigator Darrell Issa, has launched a House probe into the doctor claim. And House Republicans have highlighted the physician predicament in their weekly GOP addresses.
Here is the gist of the GOP contention: Some insurers have limited the number of doctors or hospitals their customers can go to in their new coverage plans, and some people will have to get new coverage plans under Obamacare. While a limited inventory of doctors is typical of most insurance policies both on and off the Obamacare exchanges, it runs counter to the Obama administration’s promise that people won’t have to change doctors under the health care law.
By emphasizing voters’ relationships with their doctors, Republicans are trying to exploit the momentum sparked by Obamacare’s messy rollout via HealthCare.gov, and then by Obama’s foot-in-the-mouth pledge that everyone could keep their insurance. The new charge comes as the health care website has started to stabilize.
The argument is a twist on the insurance one — although it’s unclear at this point whether it can get as much momentum.
“The big thing … is the doctor-patient relationship,” Rep. Joe Pitts (R-Pa.), who chairs the Energy and Commerce Subcommittee on Health, said in an interview Tuesday. “It’s the center of our health care system and having a good doctor- patient relationship and having a good system so that you preserve that relationship at a price you can afford is important.”
And Pitts noted that Obama repeatedly made that promise — which he did.
In 2009 — as health care reform was winding through Congress — Obama told the American Medical Association that “no matter” how lawmakers overhaul the system, “We will keep this promise: If you like your doctor, you will be able to keep your doctor. Period.”
And in early March 2010, a few weeks before the Affordable Care Act was signed into law, Obama said the legislation “builds on the current system where most Americans get their health insurance from their employer. … If you like your doctor, you can keep your doctor.”
“I can tell you as the father of two young girls, I would not want any plan that interferes with the relationship between a family and their doctor,” Obama said from the East Room in the White House.
Republicans hope their newest broadside will keep Obamacare’s alleged defects front and center in the minds of voters as the 2014 elections approach.
Issa, the chairman of the House Oversight and Government Reform Committee, has made the doctor claim the target of his latest Obamacare investigation. In letters released Monday, the California Republican asked 15 major insurance companies for key documents related to Obama’s promise that consumers could keep their existing doctors under his health care law.
Wyoming Sen. John Barrasso, the fourth-ranking Senate Republican, blasted Obama’s latest health care speech Tuesday as misguided — particularly as consumers nationwide are losing their access to insurance.
“They don’t need another press conference — they need to be able to see their doctor and get affordable care,” Barrasso said in a statement. “He took no action to help people who will lose their coverage and their doctor, pay higher premiums and become victims of identity theft because of Obamacare.”
Republican lawmakers are also spreading stories of fewer physicians available to meet the demand of millions of new health care consumers under Obamacare. GOP Rep. Phil Roe, a physician, said his northeastern Tennessee district is losing 50 primary-care residency positions.
“It is basically because the law has cut reimbursements for hospitals,” Roe said Tuesday. “They have to find savings somewhere.”
And House Republicans went to Rep. Michael Burgess (R-Texas), himself a physician, to highlight the issue in the GOP Party addresses released every Saturday — which have served as relentless, week-after-week attacks on Obamacare.
“Many families are now learning that they may not just lose their plan,” Burgess said in the Nov. 23 address. “But if they like their doctor, they may lose their doctor, too. They may lose their doctor in part because there is already a shortage of primary-care physicians. Many of these plans will now be paying doctors less — so many doctors, whose waiting rooms are already full, have chosen not to participate in the new plans.”
Democrats and Obamacare supporters acknowledge that the Affordable Care Act isn’t perfect. Still, they are highly skeptical and critical of GOP moves, arguing that those efforts are anything but genuine.
“I’m sure that Republicans are going to be coming up with new stuff all the time,” said Rep. Keith Ellison (D-Minn.), a member of the House Democratic “strike team” that will take the lead on promoting Obamacare. “Some points they have will be absolutely wrong and there will be a few where maybe there’s some merit in there somewhere for some people. But they have yet to do one thing, and that is constructively try to improve the bill.”
In general, the lower-cost bronze plans that are being launched as part of Obamacare are expected to have smaller networks of health care providers available to policyholders. That means patients would have to pay more to see a physician who isn’t in the network.
Timothy Jost, an expert on the health law and a Washington and Lee University law professor, said some people could have a reduced number of choices among doctors or physicians in a new health insurance plan — at least ones who will be in their networks. Insurers can reduce their costs by limiting the number of hospitals or doctors their customers see to just the ones that will provide them the best deal.
In the new exchanges, Jost said, there will likely be at least one plan that includes any specific doctor in a region. He said getting the best physicians on an insurer’s network is about competition among the health plans.
“If you want a plan that includes your doctor, you’ll probably be able to find one,” he said. “It’s about getting people choice. It’s choice and competition, it’s what Republicans have been talking about forever.”
Still, Jost warned that there are likely going to be some people who cannot go to their preferred doctor.
“This again is one of those issues where it’s going to be very, very easy to find anecdotes,” he said. “The question is, do people have good access to competent providers? That’s much harder to answer than whether you can find someone in your congressional district who can’t go to their primary-care provider.”