ObamaCare and Doctors

How does ACA affect doctors

How Does ObamaCare Affect Doctors?

Find out the truth on ObamaCare and Doctors. Can you really keep your doctor under ObamaCare, what impact does ObamaCare have on the healthcare industry?

ObamaCare is set to have a major impact on Doctors. ObamaCare, of course, means more patients for doctors since more people have health insurance; but is more patients always a good thing? Let’s take a look at some cases where ObamaCare will help physicians, how it may pose some new issues, and see what parts of the new law will affect doctors the most.

Can I Keep My Doctor Under ObamaCare?

No section of the Affordable Care Act (check out our summary of every provision in the PPACA) says you cannot keep your doctor, however your network isn’t something that is determined by the new healthcare law. It is up to your provider to determine the network of doctors and hospitals you have access to. So if your insurance company changes your plan or offers you a new one there is no guarantee that you can keep your doctor.

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Many Doctors Benefit From ObamaCare: More People With Health Insurance Means More Patients

The majority of physicians want to see The Affordable Care Act succeed. The bottom line is that millions of uninsured will have access to health insurance under the new law. This means an increased number of “customers” for doctors.

While the ACA was being debated in 2010, The Commonwealth Fund, a private foundation that promotes improved health care for all Americans, released a study that revealed 60 percent of Americans without health insurance did not seek needed medical care because of the cost. Under the ACA many of these people will have insurance and be able to see a doctor when they are sick or injured. This will increase the amount of patients seen by physicians.

ObamaCare and Doctors: Medicare Payments

There is an argument that Medicare payments are unsustainable. ObamaCare originally sought to cut Medicare payments to doctors to help fix this issue, instead the latest budget spends hundreds of millions of dollars to freeze Medicare payments where they are at in order to avoid dis-incentivizing Medicare doctors. Congress has passed a last-minute and temporary “doc fix” each year since 2003 to avoid lowering Medicare rates, this issue is something that we will have to face eventually (in April of 2015 Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) ending the need for ongoing “doc fixes”) . For the time being Medicare doctors and Seniors benefit from the law as Medicare get’s new reforms, patients get more rights and doctors will see more patients at the same rate.

How ObamaCare’s Focus on Quality Vs. Quantity Affects Medicare Doctors

ObamaCare includes a measure that takes away a small amount of funding from hospitals that have high readmittance rates of Medicare patients. The idea is to incentivize quality of care over quantity. Medicare spending comes at a great cost to taxpayers and at a great profit to doctors and hospitals so creating an incentive to make sure Medicare patients get proper treatment and don’t end back up in hospitals is a good thing, however some hospitals have high readmittance rates due to their population and some doctors could be negatively affected despite the provision’s good intentions.

As of December 1st, 2013 it seems ObamaCare’s Medicare reforms are already increasing the quality of care and decreasing costs. Administration officials have pointed to falling hospital readmission rates as one strong sign that cost-control provisions in the Affordable Care Act are working. Also, they noted that a growing number of insurers and health care providers are agreeing to contracts that pay for the quality of care, rather than the quantity, another indication that the law’s encouragement on that front is starting to pay dividends.

ObamaCare and Doctors: Medicaid Payments

Another feature of the ACA is that Medicaid payments to physicians will have parity with Medicare which pays much better than Medicaid. However, this only happens in states that have agreed to expand their Medicaid program. The increased expense will be the responsibility of the federal government. So Medicaid doctors in many State’s will see a higher volume of patients and will be paid at better rates. This obviously has had a positive effect on these doctors. However Medicaid doctors are not guaranteed increased payments forever, but they are insured a new influx of patients. This has the potential to lead to a shortage of doctors, especially in underserved and low-income communities, although increased funding to health centers and pay raises combat this issue..

A Shortage of Doctors

Many of the new health insurance plans have limited networks. Doctors have to sign up to accept insurance offered on ObamaCare’s marketplaces . Some of the low-cost and free plans have a very limited network and these in-network doctors could get hit with more patients than they can handle. However the law does combat this by funding health centers (especially in low-income areas), funding and training of new health care professionals, and providing incentives for doctors to practice underserved communities.

ObamaCare and Doctors: An Incentive to Practice in Underserved Communities

The Affordable Care Act also provides a 10 percent bonus to primary care doctors and general surgeons that open a practice or continue to practice in a medically underserved community. This part of the ACA mimics a provision of Medicare.


Primary Care Doctors and ObamaCare

Already Obamacare added 2.5 million young adults to the insurance rolls through a provision of the ACA that went into effect when the bill was signed into law in 2010. This provision allows children under the age of 26 to remain on their parent’s health insurance whether they live in their home or not.  Many family doctors saw an instant expansion of their practice volume and income.

Pre-existing Conditions and Doctors

Other features of Obamacare that expands physician practices are banning of the insurance industry practice of refusing to cover preexisting conditions as well as eliminating lifetime caps are health insurance coverage. These individuals add several million patient to the rolls of the insured.

ObamaCare and Doctors Summary

So, while ObamaCare is certainly a patient centric schema, many of its patient centric features are good for doctors too. Additionally, the Affordable Care Act specifically addresses certain physician concerns as well.


How Does ObamaCare Affect Doctors?

Author: Thomas DeMichele

Thomas DeMichele is the head writer and founder of ObamaCareFacts.com, FactsOnMedicare.com, and other websites. He has been in the health insurance and healthcare information field since 2012. ObamaCareFacts.com is a...

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