While open enrollment for coverage under the Affordable Care Act is closed, many of the newly insured are finding they can’t find doctors, landing them into a state described as “medical homelessness.”
Rotacare, a free clinic for the uninsured in Mountain View, is dealing with the problem firsthand.
Mirella Nguyen works at the clinic and said staffers dutifully helped uninsured clients sign up for Obamacare so they would no longer need the free clinic.
But months later, the clinic’s former patients are coming back to the clinic begging for help. “They’re coming back to us now and saying ‘I can’t find a doctor’,” said Nguyen.
Thinn Ong was thrilled to qualify for a subsidy on the healthcare exchange. She is paying $200 a month in premiums. But the single mother of two is asking, what for?
Do the math: for $70/mo this mother could get THE SAME AMOUNT OF COVERAGE as a free clinic would provide (our doctors do effectively the same work as is done in a clinic). Except, this mother would A.) Know who her doctor is, and B) Save $130 every month that she could put in an HAS for emergencies (or, if her state provides it, she could buy catastrophic insurance).
Which brings up another point: What is a Bronze Plan, really?
With deductibles up to $6,500, these are nothing more than improperly advertised “wrap-around”/”catastrophic” plans. Meaning, unless this mother and/or her children are hospitalized, or treated for a major illness/condition, this “insurance” isn’t going to do much for them.
“Yeah, I sign it. I got it. But where’s my doctor? Who’s my doctor? I don’t know,” said a frustrated Ong.
Nguyen said the newly insured patients checked the physicians’ lists they were provided and were told those physicians either weren’t accepting new patients or they did not participate in the plan.
And Nguyen says – while the free clinic isn’t technically supposed to be treating former patents who signed up for insurance, they can’t in good faith turn them away.
Dr. Kevin Grumbach of UCSF called the phenomenon “medical homelessness,” where patients are caught adrift in a system woefully short of primary care doctors.
“Insurance coverage is a necessary but not a sufficient condition to assure that people get access to care when they need it,” Grumbach said.
Those who can’t find a doctor are supposed to lodge a complaint with state regulators, who have been denying the existence of a doctor shortage for months.
Meanwhile, the sick and insured can’t get appointments.
“What good is coverage if you can’t use it?” Nguyen said.
Experts said the magnitude of the problem is growing, and will soon be felt by all Californians. But those on the front lines, like the free clinic, are feeling it first.
More than 3 million Californians are newly insured. At the same time, a third of their primary care doctors are set to retire.
That’s a substantial number of docs exiting the field of primary care. Will status quo primary care motivate enough new students to enter the field? Probably not. And that’s why our discipline needs the ingenuity and wherewithal of Direct Care.