Covered California is what ‘Broken’ Healthcare Looks Like

Breitbart California’s article last month titled “Covered California Admits to ‘Narrow Networks’ of Doctors and Hospitals” revealed officials knew insurers listed on the state’s healthcare exchange were dumping providers to keep renewal rates down. 

In response, a state investigation just acknowledged insurance companies listed on the exchange violated the law by publishing sham lists that significantly overstated the number of doctors in their networks.

The Breitbart October 5, 2014 exposé revealed that the California State Insurance Department and Department of Managed Health Care knew when officials approved a 4.2% increase for 2015 Covered California individual care premiums that insurers were engaging in “narrow networks” to limit patient access to doctors and hospitals. It appears regulators knew that without narrow networks, Covered California premium rates would have skyrocketed.

Less than two weeks later, the Covered California website’s on-line directory of doctors and hospitals available under for the 12 health-insurance plans listed on the state exchange was taken off-line “due to errors,” according to a Covered California customer service representative on their 1-800-300-1506 phone line.

Department of Managed Health Care acknowledged on November 18, 2014 over 25% of physicians listed in the medical services directories for Blue Shield of California and for Anthem Blue Cross were not taking Covered California patients or no longer had offices at their listed location.

The new revelations come as Covered California began on November 15, 2014 enrolling about 1.2 million new and continuing subscribers. Yet, the Covered California website on November 19^th was not allowing customers to login and the automated phone prompt stated that the “expected wait time is two hours.”

Officials acknowledged last month that the state-run online exchange directory listing 12 health-insurance plans was “temporarily” taken down to make improvements to the system, including speed, navigation, and search functions.

The Daily News reported last month that the California Medical Association said the Covered California on-line directory had several factual errors. “Updating and calibrating the directory is a complex, labor-intensive effort,” Covered California officials replied in a statement. “The files are very large, and the search tool cross-references literally tens of thousands of doctors, hospitals and other providers across a dozen insurance companies.”

The Los Angeles Times reported unsuspecting patients appear to have suffered huge additional medical bills for using advertised network doctors and hospitals for medical tests and procedures, but were actually “out-of-network.”

When President Obama in his January, 2014 State of the Union speech said, “few things exposed hard-working families to economic hardship more than a broken health care system,” he may have been referring to Covered California.