December 8, 2013

Not News in Calif. Press: Doctors Not Joining Covered California Exchange

On Friday morning, Richard Pollock at the Washington Examiner (HT Ed Driscoll at PJ Media) broke an important story about the the large number of doctors choosing not to participate in Covered California, the state’s Obamacare exchange.

The odds that the agenda-driven press in the formerly Golden State of California was already aware of this problem and chose not to report on it would seem to be pretty high — and they’re still ignoring the story, despite its obvious impact on the availability of medical services once Obamacare kicks in on January 1. Excerpts from Pollock’s report follow the jump (bolds are mine):

Doctors boycotting California’s Obamacare exchange


An estimated seven out of every 10 physicians in deep-blue California are rebelling against the state’s Obamacare health insurance exchange and won’t participate, the head of the state’s largest medical association said.

“It doesn’t surprise me that there’s a high rate of nonparticipation,” said Dr. Richard Thorp, president of the California Medical Association.

… “We need some recognition that we’re doing a service to the community. But we can’t do it for free. And we can’t do it at a loss. No other business would do that,” he said.

California offers one of the lowest government reimbursement rates in the country — 30 percent lower than federal Medicare payments. And reimbursement rates for some procedures are even lower.

In other states, Medicare pays doctors $76 for return-office visits. But in California, Medi-Cal’s reimbursement is $24, according to Dr. Theodore M. Mazer, a San Diego ear, nose and throat doctor.

In other states, doctors receive between $500 to $700 to perform a tonsillectomy. In California, they get $160, Mazer added.

Only in September did insurance companies disclose that their rates would be pegged to California’s Medicaid plan, called Medi-Cal. That’s driven many doctors to just say no.

They’re also pointing out that Covered California’s website lists many doctors as participants when they aren’t.

… “This is a dirty little secret that is not really talked about as they promote Covered California,” (executive director of the Alameda-Contra Costa Medical Association Donald) Waters said. He called the exchange’s doctors list a “shell game” because “the vast majority” of his doctors are not participating.

Covered California’s continued listing of doctors who have not agreed to participate is a clear example of consumer deception. How many of Covered Cal’s enrollees have chosen a particular plan because their doctor is supposedly participating in it, but really isn’t?

This situation promises to lead to contentious incidents in doctors’ offices starting on January 1, when patients who had every expectation of coverage with a particular doctor will find that they don’t have it. That’s all on Covered Cal.

Searches at 8 a.m. ET on “California doctors” (not in quotes) at the Los Angeles Times, San Francisco Chronicle, San Jose Mercury News, and San Diego Union Tribune, return nothing relevant.

The Mercury News has what amounts to a puff piece about how “Covered California has fared better with health reform than Obama.” The Union-Tribune had two Covered Cal-related items, one from the Associated Press dealing with how it “shares data without consent,” and the other by reporter Paul Sisson about how the exchange’s web site is “still sluggish.” None of the three stories just identified address doctors’ participation.

In a Thursday column carried at Real Clear Politics, Debra Saunders credited the LA Times for reporting that “Health Net individual policyholders will have access to less than a third of the doctors on employer plans.” That was in mid-September, and the referenced report did not mention doctors choosing not to be in Covered Cal at all. It even mentioned the California Medical Association, noting that “based on its research, the organization is skeptical of the state’s claim that its health plans will cover about 80% of all California physicians.” But reporter Chad Terhune either didn’t ask CMA why it believed that, or got an answer — docs won’t participate — that he didn’t like and chose not to report. Which is it, Chad?

California’s lockstep press is still acting as if what Pollock has reported at the Examiner doesn’t exist. Sometimes you have to wonder why they even bother showing up for work.

Cross-posted at


1 Comment

  1. [...] rates for services under Obamacare (e.g., California, as noted earlier today [at NewsBusters; at BizzyBlog]), are choosing not to participate in any Obamacare plan. People who lost their plans can only see [...]

    Pingback by BizzyBlog — December 8, 2013 @ 9:25 pm

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