Seniors lose insurance and doctors under Obamacare [Thank you, AARP /sarc]

Retired chemist Edward Schokowitz was incredulous when he received a letter from Horizon Blue Cross Blue Shield of New Jersey early last month saying his Medicare Advantage Plan, which had no premium, would be eliminated next year.

“They took all the senior citizens and threw us out of the plan. They now want to give us the same plan for $153 [per month],” he told the Daily Caller. “The President said you can’t be kicked out of your plan. He lies.”

Schokowitz is one of many Medicare beneficiaries now learning that — like Americans who buy insurance on the individual market — they are losing their insurance, and in some cases their doctors, under Obamacare.

Private insurance companies that cover patients with government funds under the Medicare Advantage program have quietly started to dump doctors and patients because of Obamacare budget cuts.

Schkowitz, 75, who lives in a senior citizen complex near Atlantic City, would also pay more for prescription drugs under the new plan. The co-pay for a three-month supply of one of his medications increases next year from $7.50 to $54.00.

Thousands of New Jersey residents are suffering the same fate . Currently, 74,000 Garden State residents are enrolled in Blue Cross Blue Shield Medicare Advantage. Nearly half have zero-premium plans.

But in 2014, New Jersey Horizon Blue Cross Blue Shield is eliminating all zero-premium plans with prescription drug coverage and all but two of its other plans with monthly fees.

New Jersey Horizon Blue Cross Blue Shield spokesman Tom Vincz tells the Daily Caller that “due to rising health care costs and cuts to Medicare Advantage we had to make these product changes.”

The company is asking elected officials to avoid further cuts to the program, “We’ve been lobbying Congress to help insure that Medicare Advantage is appropriately funded to avoid further increases in premiums and changes in the product,” Vincz told TheDC. “We are hoping to make this a one time experience.”

Federal payments to Medicare Advantage HMOs will decrease seven to eight percent in 2014, according to one prominent health care industry analyst.

Overall, the Affordable Care Act slashes Medicare Advantage funding by $156 in ten years, a reduction that Democrats and many journalists long insisted would not harm patients. Republicans, however, have continually warned of dire consequences.

Now, insurance companies, feeling squeezed, are nixing doctor contracts and patient plans to save money. Medicare Advantage plans are being dropped all over the country.

Nearly 4,000 UnitedHealthCare Medical Advantage members in Hawaii will have their plan terminated next year, according to the Honololu Star-Advertiser.

UnitedHealthCare Medical Advantage is also eliminating two plans in Broward County, Florida.

In Portland, Oregon, Providence and Humana are nixing their PPO plans, which allow patients to see any Medicare doctor. HMO plans, on the other hand, give patients access to only doctors in the network.

UnitedHeatlhCare is also dropping two of the plans it offers Western Pennsylvania residents.

Avalere Health, a consulting group, said in a little-noticed report this September that patient access to Medicare Advantage Plans will decline next year because of the Obamacare cuts.

Relying on data provided by the Center for Medicare and Medicaid Services (CMS), Alvalere concluded, “A majority of the counties across the country will see a decrease in the number of MA plans available from 2013 to 2014.

“Approximately 80 percent of counties in the South and Midwest will see a reduction in MA plan options, while slightly more than half of the counties in the Northeast and West will have fewer plan options.”

Avalere said the total number of plans will decrease by 5.3 percent. Before Obamacare the number of plans was increasing.

Medicare Advantage patients accustomed to seeing any Medicare doctor they wish are going to be particularly hard-hit under further Obamacare budget cuts.

Avalere chief executive officer Dan Mendelson tells the Daily Caller, “There are going to be fewer PPOs in the program. That product is difficult to maintain.”

Even when insurance companies continue to offer the same Medicare Advantage plans some are increasing prices.

The Aetna Medicare Advantage Standard HMO plan for West Philadelphia residents in the 19104 zip code now costs $39 per month. In 2014, the premium increases to $75.50. Another plan will increase from $140 to $172.

As prices increase for some Medicare Advantage patients their access to doctors withers.

Medicare Advantage HMOs last month started to inform doctors nationwide that their contracts will not be renewed.

Noted Obamacare critic Betsy McCaughey tells the Daily Caller that the cancellation of contracts decreases costs for Medicare Advantage HMOs by reducing doctor utilization. Fewer doctors available will make it harder for patients to get appointments.

Lazlo Weiss, a Brooklyn ophthalmologist, learned early last month that his Medicare Advantage contract with Empire Blue Cross Blue Shield is being canceled. “You have patients that you have a relationship with some over many years and you know their problems and they know you and then all of a sudden they are no longer your patients,” he told the Daily Caller. “I hope something can be done before there is more harm to these people.”

New York State Medical Society president Sam Unterricht said that United Health Care Medical Advantage is canceling the contracts of 2,100 New York providers. Emblem Health is also axing doctors but Unterrich has no exact figures.

“We think [Congress] should investigate to see if anything can be done,” Unterrich said. “This affects a lot of patients and physicians adversely.”

Unterricht says the New York State Medical Society has written the entire New York Congressional delegation asking for help. The office of Democratic Sen. Charles Schumer of New York told Unterricht’s staff members that they will look into the matter.

In Ohio, UnitedHealthCare Medicare Advantage it is cutting doctors loose because of Obamacare.

UnitedHealthCare spokesman Kevin Shermach told the Springfield News Sun that the company is “dealing with the financial pressures created by severe cutbacks in Medicare Advantage funding.”

It is unclear how many doctors are being axed. But Ohio State Medical society official Todd Baker told the Daily Caller it is happening across all specialties.

SAS Surgery and Vein Specialists, a four physician practice in Springfield, Ohio, just had its UnitedHealthCare Medicare Advantage contract canceled, leaving more than 400 of its patients in the lurch. Some had been under the care of their doctors for decades.

Becky Browning, the office manager for the practice, tells TheDC, “Patients have expressed concern and fear about losing the doctor they are comfortable with. The senior citizens don’t understand why this is happening.”

UnitedHealthcare Medical Advantage has also terminated the contracts of doctors in Connecticut, Florida and New Jersey. Exact numbers could not be determined for those stats.

But Rhode Island Medical Society spokesman Steve DeToy says UnitedHealthCare informed him that the group is cutting 20 percent of its Medicare Advantage doctors.

DeToy told the Daily Caller that dermatologists, rheumatologists and endocronologists who remain in the program are worried they will not be able to handle anymore patients.

Democrats and many journalists have long insisted that Obamacare cuts to Medicare would not harm patients and dismissed Republican objects as partisan grandstanding.

The Affordable Care Act cuts $717 billion from Medicare–$156 from Medicare Advantage–over ten years. Obamacare supporters claimed the government pays more to insure seniors under Medicre Advantage than it does under traditional Medicre so the cuts were justified.

The Romney presidential campaign last year repeatedly attacked Obama for taking the axe to Medicare. But journalists sided with Obama.

Last year, Time magazine staff writer Kate Pickert said the Romney campaign assertions were patently false. Her October 12, 2012 “Fact Check” post for the magazine’s Swampland blog said the notion “that the Affordable Care Act struck a dangerous blow to Medicare that will change the program in fundamental ways is untrue.”

Pickert insisted that the Medicare Advantage cuts were a prudent cost-saving measure.

Mitt Romney also charged during the campaign that Obama was “destroying the Medicare Advantage program.”

Traditional Medicare covers 80 percent of the fees for any doctor that accepts Medicare. Patients buy “Medigap” insurance to cover the rest. They must also obtain separate prescription drug coverage.

Medicare Advantage HMO plans cover 100 percent of the cost for in-network providers only and generally include drug coverage. Medicare Advantage PPOs allow patients to visit any doctor who accepts Medicare but they pay out of pocket and then get partially reimbursed.

Zero-premium plans sound free but they are not. The government deducts $104.90 from the monthly social security payments to everyone enrolled in both Medicare Advantage and traditional Medicare

In August Rubio, who frequently expresses concern that his mother will suffer under Obamacare, said that “the chances are that soon seniors will open up the mail to the bad news that your Medicare Advantage…has been changed in negative ways because of Obamacare.”

Time magazine’s Pickert last month likened Rubio and other Republican critics of the Medicare cuts to chicken littles.

“Back in 2009 and 2010, one of the harshest criticisms of President Obama’s health care law was that it would hurt seniors,” she opined on October 14. “Four years later, with the ACA in place, it appears that worries about the future of Medicare Advantage have not come to fruition — at least not yet.

“But Republicans have not given up. Some still say the program is in jeopardy thanks to Obamacare.”

But warnings about Obamacare’s threat to seniors were not just coming from politicians.

According to Forbes magazine, Citi health industry analyst Carl McDonald told clients on February 18 that he expected 7 to 8 percent cuts to the Medicare Advntage program in 2014.

He said the funding reductions would be “enormously disruptive to Medicare Advantage, likely forcing a number of smaller plans out of business and creating disarray for many seniors.”

MIT professor Jonathan Gruber, architecht of the Massachuseets health insurance law that was the model for Obamacare, told the Daily Caller that seniors who stand to lose their doctors and Medicare Advantage plans must be sacrificed for the greater good.

“It is a tiny effect compared to the benefits of this law. There is small fraction of Americans who might need to change doctors or plans because of the law.”

Asked if Obama had betrayed seniors with his famous promise to Americans that they could keep their doctor and health plan Gruber insisted that, “He was not really talking about seniors.” But in fact, the president’s promise, in dozens of televised speeches was all-inclusive and unqualified. (Related: Obama denies ‘you can keep it’ videotaped promises)

Pressed further, Gruber, who is normally quite expansive with journalists, said, “I have to go” and hung up the phone. (Related: Media skip disclosure of paid Obamacare shill)

Robert Zirkelbach, spokesman for America’s Health Insurance Plans, said another aspect of the Affordable Care Act has also sparked changes to doctor networks and Medicare Advantage policies. The new health insurance tax is “extremely disruptive” to the industry, forcing companies to find new ways to cut costs, he contended.

A 75 y/o man has his premium for his drugs go from $7.50 to $54.00. That is an increase of 720%.

I suspect that he also voted for Obama, but this kind of increase isn’t good for many of us who are now on Soc Sec.

I earned $52.00 a week for a full 40 hours when I started work at 17. My Soc Sec isn’t very much- as most of us worked at or just above minimum wages for years. We managed to buy cars—own our own houses—pay our taxes & lived a decent if not lavish life.

Many of us never worked where a pension was offered. So, we are dependent on Soc Sec. I happen to own my property- and all my vehicles, furniture, etc. However, I also don’t have medical issues. I take no chronic prescriptions and I don’t see a doctor on any kind of regular basis. I manage to do all my ranch chores each day & I don’t spend money on eating out, etc. I watch grocery ads & buy when things are on sale & I can put them into the freezer.

I also have voted Republican since I turned 21, and while I suspect that many in NJ voted for Obama-—the AARP was a treasonous organization that sent tons of brochures to seniors telling them to vote for Obama & that they would have such wonderful medical care under this health plan.

They should be put out of business for their actions, which many seniors swallowed. I won’t have anything to do with them.

Private insurance companies that cover patients with government funds under the Medicare Advantage program have quietly started to dump doctors and patients because of Obamacare budget cuts.

Insurance companies are given a set amount of money for each person they sign up for Medicare Advantage. Some rumors put the figure at $100,000... a year per person... Any money the 'Advantage' plan doesn't spend on the person, they get to keep. It's why they advertise everywhere... it's one big cash cow with perverse incentives ...

Why a cash cow?

Because boomers are still in their sixties and younger. Not a time when medical care is costly (compared to what it will be in 10 years.)... Advantage programs can dump promises every year and it's totally legal. IN the mean time sane insurance plans like the medi-gap 'F' plan (yes, it pays excess charges - which will keep a person from going broke when they have medical needs) will become unavailable to the elderly.

One perverse incentive in the Advantage plans is to deny expensive medical care - care like operations... and to instead offer a pill... remember, 'the plan' gets to keep ALL money not spent on a person in any given year... Same for the 'doctors' they hire... Any money NOT given to a doctor is money the Insurance company gets to keep. Doctors working for salary might not be the top of the class guys... plus if they ask for too many high cost items for the patients they'll be replaced. Incentives work that way... it's what makes some 'perverse'.

Obama's reducing what he's paying insurance companies who deal in Advantage' to help the ObamaCare scam look better... The goal appears to be for the US Government to take a large cut of health care dollars. Take those dollars - skimming them from citizens, Insurance companies, doctors, health care providers etc. and keeping the money for themselves... and the dependent ones who keep them in office. These are liberal elites at their worst.

Private insurance companies that cover patients with government funds under the Medicare Advantage program have quietly started to dump doctors and patients because of Obamacare budget cuts.

Why a cash cow?

One perverse incentive in the Advantage plans is to deny expensive medical care - care like operations... and to instead offer a pill... remember, 'the plan' gets to keep ALL money not spent on a person in any given year... Same for the 'doctors' they hire... Any money NOT given to a doctor is money the Insurance company gets to keep. Doctors working for salary might not be the top-of-the-class guys... plus if a plan doctor asks for too many high cost items (MRI's specialists etc) for the patients they'll be replaced. Incentives work that way. It's what makes some 'perverse'.

we have SCAN which is a non profit Advantage plan and they not only have top doctors but you can even have services not within the plan.

I had Cyberknife to cure my lung cancer and they paid 100% of it and all I have had to ever pay was a co pay for the PET scans.

They did increase the co pays for next year to cover what obama stole, but not that much.

Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.