Since Covered California shut down the doctor search portion of its website, prompted by a report by KPIX-CA, many patients who chose insurers based on that search tool have learned that a large number of doctors will not accept the insurance plans they have purchased. Doctors were also shocked at this news.
Many doctors discovered that they were listed as "in-network" on the Covered California website, though they are not accepting patients with those CoveredCalifornia policies.
Dr. Marie President, an Internist affected by the website problem, explained to KPIX-CA: "We found that we were already signed up and we were astonished because we hadn't signed anything yet. We can't [accept them], we'll be out of business."
Many doctors are now choosing to opt out of the plans under Covered California.
Obamacare mandates what insurers charge patients, but it doesn't mandate just how much money insurers reimburse doctors. Some doctors are receiving less than favorable reimbursements.
A standard doctor's visit could cost a patient $134, a standard insurance policy would reimburse them $87, but they would only get $59 from that same insurer under one of the new Covered California policies. Medicare would pay more- $84.
"There's a concern about how these are structured- whether the reimbursement will be sufficient," Dr. Ruth Haskin from the California Medical Association said.
Dr. President added, "We can't maintain operations at that level of reimbursement."
Insurers do pay more to doctors who are part of large medical groups who negotiate with insurers on their behalf, but many believe that small practices and specialists are being price gouged which has resulted in fewer doctors accepting the new policies and fewer options for Californians signing up for those plans, Dr. President explained.