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Doctors May Eat Costs For ObamaCare Enrollees Who Fail to Pay Premiums

Doctors are worried that due to a quirk in the Affordable Care Act, they may end up bearing the costs of premiums that enrollees stop paying.

According to the law, people who stop paying their premiums have a three-month grace period in which they can still receive care.

“This law provides a 90-day grace period for people who have subsidized ObamaCare exchange plans and stopped paying their premium," Betsy McCaughey, health care author and former New York lieutenant governor, told Fox News.

Insurance companies, however, are only obligated to pay for the first 30 days—leaving 60 days up for grabs.

"You're still entitled to care for another 60 days," said John Goodman of the National Center for Policy Analysis. "The insurance company doesn't pay, you don't pay, who pays? Well, the doctors and the hospitals have to eat it.”

“That's a very strange feature of this new health reform."

The American Medical Association has sent out a sample letter for doctors to give to patients informing them that they may have to bear the costs of care of they miss a premium and lose their coverage.

“This letter is intended to let you know if you lose your coverage, you may be obligated to pay the full cost of services that we provide to you,” it reads.

Doctors and hospitals might not even know, however, if someone missed a premium and no longer has insurance. The AMA asks that administration require insurers to notify doctors when a patient fails to pay his or her premium.

Washington state has already passed such a law.

Scott Gottlieb of the American Enterprise Institute predicts that the policy will “increase bad debt” among providers and hospitals.

“They're used to absorbing a certain amount of bad debt, but for a lot of individual doctors - they're not going to be able to absorb these costs so they're going to be really stuck,” Gottlieb said.

Experts on both sides of the ObamaCare debate continue to produce numbers about how many enrollees are actually paying their premiums. A McKinsey survey estimated that 53 percent of previously uninsured enrollees had paid, while 86 percent of those previously insured had paid.

Sources: Fox News, Forbes


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