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What to Expect if ObamaCare is Repealed

Wednesday, May 24, 2017   (2 Comments)
Posted by: Brook Schales
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Laura Farr | OANP Executive Committee

Efforts to repeal ObamaCare are highly contentious and still with no clarity on whether they’ll be successful or not. But the question of “What to Expect” that’s on everybody’s mind can be broken down into three components for NDs: Impact on access, patients and practice.

Access to NDs
One of the smallest parts of the ACA has been an important one for naturopathic doctors – the provider non-discrimination provision – which prohibits insurers from discriminating against any provider in either coverage or participation in a plan. While maddeningly difficult to enforce (see article about the HealthNet lawsuit), this provision has definitely opened access to NDs around the country and moved us out of the “complementary and alternative” riders of most insurance plans and squarely into the terms and conditions of typical out-patient medical insurance.

There’s good news on this front.

First – nobody expects that this part of the ACA would be one of the sections repealed. It has no financial impact, and has not been a part of any repeal discussions.

Second – OANP was successful in working with the Oregon insurance division in 2015 to embed identical non-discrimination language into state law. So even if that were to disappear in federal law, we would still be covered in Oregon!

But other issues around access may not look so rosy.

Impact on Patients
Most reports indicate that the Republican health care plan would have the following impacts on patients:

  • Hundreds of thousands of Oregonians could get kicked off of Medicaid, potentially tripling the state’s uninsured rate.
  • Ends the individual mandate to purchase insurance.
  • Allows insurers to charge higher prices to people with pre-existing conditions.
  • Allows states to opt of Essential Health Benefits – the minimum floor of what every insurance plan is currently required to cover for all members.
  • Increases costs for seniors.

Impact on Your Practices
Clearly, the prospect of suddenly revoking insurance for hundreds of thousands of Oregonians would return us to a state of affairs of a decade ago: patients who can’t afford to visit the doctor, complex medical conditions being left untreated and shifting costs to expensive emergency departments and away from primary care.

For those clinics who see a high volume of Medicaid patients, you could see a dramatic reduction in patient visits and the commensurate loss of clinic revenue as those patients shift to hospital-based care (or no care!).

While the bill to repeal ObamaCare has passed the House, it seems to still be facing an uphill battle as it moves over to the Senate for consideration, where lawmakers are expected to make substantial changes. Stay tuned, and stay engaged!


Kerie Raymond ND says...
Posted Wednesday, May 24, 2017
A big concern I'm hearing from patients is about pre-existing conditions. Patients are now very concerned about how I code things, and repercussions down the line.
Orna Izakson ND RH (AHG) says...
Posted Wednesday, May 24, 2017
Thank you for writing this up. I've been wondering for my patients and myself as a patient! —Orna

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