Obamacare: woman hit with huge bill because the hospital closest to her is not on the healthcare exchange

  According to this story, a woman in Seattle has been hit with a large bill because the hospital which is right around the corner from her residence is not on the healthcare exchange: 

Alex Szablya just wants the best health care she can get for her children. So she got a gold plan, the highest level possible with the Washington Health Benefit Exchange.  She picked a plan with Lifewise, an affiliate of Premera Blue Cross.

In early March, her 16-year old daughter had a medical emergency. Alex drove her to the nearest hospital, which was Seattle Children’s. Alex says doctors there felt her daughter’s situation was so dire she needed to be admitted to the hospital immediately. She was there for nine days.

Then came news that her stay, which involved specialized mental health care for adolescents, was going to cost $36,000 and her insurance would only pay for half because Seattle Children’s was considered on out-of-network facility.

She thought by going for the highest premium PPO gold level coverage offered the state exchange, a majority of the bill would have been covered.

“I’m paying a premium for that and I’m willing to pay that premium, but I expect to get services that are not so limited by the insurance companies,” she said.

  Supporters of the president and of Obamacare will claim this is merely anecdotal evidence that the plan is not all that it is cracked up to be and that we should not cite one example as proof that the healthcare reform law is not working because for many the law is working.

  However this might be symptomatic of a much larger problem which supporters of the law would rather not think about. 

   Here in New Hampshire there is only one insurance provider, Anthem Blue Cross Blue Shield, on the healthcare exchange and they offer only three plans; the gold, silver, and bronze plans. But the news gets worse for New Hampshire residents because only 16 of the state’s 26 hospitals have been approved by Anthem, meaning the above scenario could play out hundreds, if not thousands, of times in this state alone in the years to come even if you sign up for the gold plan.

Harte’s clients have plenty to worry about. According to the Concord Monitor, just one insurer, Anthem Blue Cross Blue Shield, is offering plans on the Granite State’s exchange, and it has contracted “with [only] 16 of the 26 acute general care hospitals in the state.” Concord Hospital was not among them, leaving residents of the state capital who buy coverage through Anthem with the option of paying expensive healthcare bills or driving to Manchester, the nearest in-network hospital.

  So why did Anthem only contract with just over half of the hospitals in New Hampshire? It was the only way they could keep premiums down under Obamacare:

By contracting with 16 of the 26 acute general care hospitals in the state, Anthem was able to keep premium costs 25 percent lower than they would be if all hospitals in the state were part of the network, according to a statement from the insurer yesterday.

  This is the situation people who have lost their healthcare coverage due to Obamacare face in the state of New Hampshire and I find it hard to believe we are alone.

  Obamacare was supposed to provide more people with more healthcare options, but at least in New Hampshire that has not been the case. Perhaps if there was more than one insurer on the Obamacare exchange there would be more competition which would lead to lower rates and more hospitals on the exchange, but it certainly did not work out that way.