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Limited Health Care Options Coming to Some

Purchasers of subsidized Anthem plans via the Affordable Care Act won’t be allowed to see doctors at Concord Hospital.

Jennifer Patterson of the New Hampshire Insurance Department speaks before the Health Care Reform Oversight Committee on Sept. 4, 2013. Credit: Tony Schinella
Jennifer Patterson of the New Hampshire Insurance Department speaks before the Health Care Reform Oversight Committee on Sept. 4, 2013. Credit: Tony Schinella

One of New Hampshire’s largest insurers confirmed what many conservatives had expected and believed: When the Affordable Care Act is implemented next year, not only will people be forced to buy insurance, but people who need subsidies will not be able to access care at the hospital closest to their homes.

The Health Care Reform Oversight Committee on Sept. 4, featured testimony by a New Hampshire Insurance Department official and officials from Anthem Blue Cross Blue Shield, about the upcoming changes in health insurance coverage for many people currently without coverage.

Under the ACA, Americans without insurance will be forced to purchase a plan or be subject to fines. People needing insurance who are earning 400 percent above the poverty level will get access to plans that will be subsidized at various levels. There will also be non-subsidized plans available for those without insurance or above the income threshold.

However, the only company offering subsidized plans through the exchange, Anthem, has made side agreements with a little more than half the state’s hospitals, limiting coverage to thousands of potential new customers. Hospitals that have not signed onto the agreement will not be able to accept Anthem for coverage and those patients won’t be able to see doctors outside of the new network in 2014.

Hospitals that will not be covered by Anthem exchange plans include Concord Hospital, HealthSouth Rehabilitation Hospital of Concord, New Hampshire Hospital in Concord, Northeast Rehabilitation Hospital in Salem, Parkland Medical Center in Derry, Portsmouth Regional Hospital in Portsmouth, and Southern New Hampshire Medical Center in Nashua, as well as others.

Paula Rogers, the director of government affairs for Anthem, confirmed that the company had made contract agreements with 14 of the state’s 26 hospitals in an effort to contain costs while ensuring that hospitals in the agreement had “some expectation of increased volume” in the wake of those hospitals agreeing to lower prices for Anthem. She said many policyholders would be grandfathered in for a short period of time. As well, exceptions would be made for emergency situations, or current care situations, like a woman who is pregnant who switches providers between now and then. Rogers added that she was expecting “some consumer pushback” after the details of the plans are approved by the federal government in the coming weeks. The plan won’t also be put into place until January 2014, she said.

The state had already approved of the plans, according to Jennifer Patterson of the New Hampshire Insurance Department, but she said she wasn’t at liberty to discuss the details until October, calling the information “proprietary.” She added that she could only acknowledge that Anthem was a participate because it had become "common knowledge," but other information was not. 

Republicans on the committee were critical of the news, with state Sen. Andy Sanborn, R-Bedford, saying it proved that the president lied when he said that ObamaCare would allow people to keep their own doctors or hospital. He questioned the legitimacy of not being able to talk about the specifics when hospital officials in his district were calling to complain about the network limitations.

“There are hospitals no longer in the network … insurance brokers that are concerned … define to me what is common knowledge,” he said. “It’s 24 days out … we have an obligation to talk about this.”

State Sen. Jeb Bradley, R-Wolfeboro, said it seemed to go against the commitment that the federal plan wouldn’t ration care, calling the plan “controversial and confusing” especially in the wake of higher premiums and “elimination of choice.”

However, state Rep. Ed Butler, D-Hart’s Location, countered that the plan was being put in place to control costs and not to have 15 to 20 percent increases.

“In order to do that, you need this network of hospitals (and) you will guarantee them increased volume of consumers,” he said. “In return, they will control their costs.”

Details about potential plans, plan management, and costs of premiums, copays, coinsurance, and deductibles for Anthem or other potential carriers are not yet known at this time. However, the rates and information is expected to be available in October. 

JPF36 September 04, 2013 at 05:33 PM
What happened to Obama's PROMISE that " if You like your Doctor, you can keep your Doctor????
JPF36 September 04, 2013 at 06:34 PM
I wonder what the spin will be from the Democrats on this blog???? How can they justify these actions????
Robert B Butts September 04, 2013 at 06:58 PM
The best I can say for ACA is that it's not necessarily worse than the current system. IMO we should have done single payer. There's really no compelling argument to keep the current system or sabotage ACA which is what the blowhard JFP's GOP offers as "solutions".
Nicholas Luoma September 04, 2013 at 08:28 PM
This is actually because hospitals over charge. What never ever gets talked about and is always left off the bill (especially a problem with Concord Hospital) are the facility charges. How much the share holders of the Hospital are putting in their pockets. The hospitals not signing onto the agreement are the problem. That's the part of the discussion which gets left out.
John Edward Royal September 05, 2013 at 12:11 AM
I think letting the wolf (Anthem) guard the chickens is a mistake and is designed to cause the failure of the ACA in NH. Why would they exclude access to any medical facility or Hospital outright to keep them out when they are so vital to local care of the low income and disabled. when the ACA is supposed to guarantee access to all. The Insurance Industry Has a lot of reasons to influence the system to fail. Mainly their lost profits. After being injured on the job and having Anthem BCBS forcing me to suffer for the last Thirty years with no access to reasonable medical care or the surgeries that could have made my life worth living so they could profit and pay their shareholders more money. Now they are going to force me to use Elliot or CMC when I have no means of being transported available to there from Concord and I'm an ex-Catholic that does not want to be a patron of a hospital and a Church that will not observe the medical political, choice of faith, the rights of women, and the freedom of choice we as non religious human beings have with out a politically based medical denial system. The system is already corrupted and money that should have gone into the care of people to be put in pockets that should never have been allowed in the line.
Joseph R September 05, 2013 at 06:53 AM
Wait a second here...I have Anthem for years, and go to Concord Hospital, and the Hitchcock Clinic (part of CH) across the street. Does this mean I'm screwed?
Joseph R September 05, 2013 at 07:15 AM
OK, I calmed down here. It says: "Purchasers of subsidized Anthem plans via the Affordable Care Act won’t be allowed to see doctors at Concord Hospital". My wife got Anthem when she worked for the state many years ago. We're both retired and have Medicare as our primary, and Anthem next. So it sounds like we're OK.....right?
annie bennett September 05, 2013 at 07:42 AM
Any governor of any state population can implement stipulations toward a new bill unless mandated not to by congress! Regulations are written in 'stone' but can be amended to fit that states economy as long as that doesn't change the intent of the bill! Got that! We do as retirees of regulation handbooks that serve the public! but always look for the simplified version! It's been said 'one has to be 'coherent and public understanding when compliling and publishing regulations for the public!' The craziness arrives after the reg is published and phone calls, questions, complaints flood the network! ha! then publishers, like us retirees run and hide as we get the blame and not the creator of the reg! ha! But I digress! ha! good luck again! ab
Marty Jano September 05, 2013 at 07:45 AM
@Nicholas. CH is not-for-profit, no share holders. ACA is the problem, as usual it is low information voters like you that perpetuate dumb policies like this.
gjc September 05, 2013 at 10:48 AM
Be grateful that if you received subsidized insurance that you have access to many doctors and hospitals. You can't always have everything you want.
Jane Aitken September 05, 2013 at 12:06 PM
I had BC/BS for 45 years... but lost it due to Obamacare and Romneycare's price hikes.
Dave Larkin September 05, 2013 at 08:21 PM
It will work for his Homies.
Lonnie LaShum September 06, 2013 at 07:00 AM
John Edward Royal; I find your story very hard to believe. 30 years without proper medical treatment? Why would you Make yourself suffer so long? There are many options out there that you failed to take. There is no need to stretch the truth to try and make a point. The system is screwing people and not too many people are seeing it. But the great thing is with stories like this eyes are popping out. Remember what demodrat nancy said, lets pas this bill so we can see what it contains. Now we all see. Did you vote for obama?
Lonnie LaShum September 06, 2013 at 07:03 AM
"Jane Aitken September 05, 2013 at 12:06 PM I had BC/BS for 45 years... but lost it due to Obamacare and Romneycare's price hikes."xxxxxx So NH has Romneycare as its standard? I thought it was another state that had it. Wow, learn something new every day. How could the gubner if one state force another state to use his medical plan?
JPF36 September 06, 2013 at 09:01 AM
If ObamaCare is such a great idea then why aren't ALL the politicians in Washington DC, including BARRY himself being forced (like we are) to participate in it????
Nicholas Luoma September 06, 2013 at 10:20 AM
@Marty, Non profits are even worse! It is clear you didn't read what I wrote. It is also clear you do not have an understanding of economics on the same level as I do.
Jane Aitken September 06, 2013 at 10:57 AM
Dear Lonnie: My insurance comes from Massachusetts, not NH.
Bonnie Ward September 08, 2013 at 05:54 PM
By leaving it up to each state to implement, the consumer gets screwed. A universal mandate would be FAR better but the GOP won't ever get behind providing services for people.
JPF36 September 08, 2013 at 09:02 PM
Bonnie, So we the Public are better off being forced into a plan (Obamacare) that even our Glorious leader himself and the rest of the Politicians in Washington won't be participating in??? How is it that Barry the Great isn't being FORCED into participating in this pile of excrement, that he created, like the rest of the LEGAL citizens of the USA???

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