June 12 2014
Obamacare vs. Women's Choices
Carrie Lukas and April Ponnuru
Women have been told since the earliest debates about Obamacare that they would be among its biggest winners. Some of the best-advertised features of the law, such as first-dollar health-care coverage and a prohibition against charging women higher insurance premiums, were specifically designed to make the law attractive to women. So it must be incredibly frustrating for those politicians and advocacy organizations that continue to try and persuade women that Obamacare is good for them that women just aren’t buying it. In fact a majority of women still oppose Obamacare. Even the Kaiser Family Foundation, which tends to find results more favorable to Obamacare than other pollsters, has found that more women disapprove than approve of the law.
There’s a reason women see through Obamacare’s hype. Women are the primary consumers of health-care, and make an estimated 80% of the health-care decisions for their families. They want their health insurance to provide access to doctors in their communities that know and can address their families’ needs. And this is one of the key areas in which Obamacare is letting women down.
While we still don’t have the details on just how many of those celebrated new Obamacare enrollees were among those kicked off their insurance plans, we doubt that many of those falling into that category are joining the celebration. Changes in health insurance coverage mean changes in provider networks, which can result in interruptions in health care as well as major administrative headaches for the women overseeing their families’ health-care needs.
Unlike men, women with health insurance coverage often have two primary care doctors—a primary-care physician and an obstetrician-gynecologist. Add to that any specialists they require and a network of doctors they have often painstakingly assembled on behalf of their family members—pediatricians for their children and a multiplicity of doctors for aging parents—and you can imagine what’s at stake for many women.
Good doctor-patient relationships often take years to form and they are not easily remade. But many women will have a very difficult time finding an Obamacare plan that covers the two or more doctors that they require, because physician networks are being narrowed dramatically by many Obamacare plans in an effort to keep costs down. Hospitals are being cut out, too. The upshot: Many women are losing their access to the first-rate care they have come to expect.
The Associated Press recently told the story of Michelle Pool, a 60-year-old Californian with ongoing health issues. Her exchange plan seemed like a good deal until she learned it did not cover her doctor. “It’s not fun when you’ve had a doctor for years and years that you can confide in and he knows you. I’m extremely discouraged. I’m stuck.”
So are a lot of people. It’s an inevitable consequence of Obamacare. Its heavy regulations on insurers leave them with few cost-controlling options. Narrowing the range of doctors and hospitals a patient can access is one of the only levers they retain. In testimony before Congress, American Enterprise Institute scholar Scott Gottlieb highlighted a few examples of what these narrow networks mean to individual communities: one low-cost plan in Florida offering only seven pediatricians in a county with 260,000 children; one New York City plan without a single gynecologist in its provider network, another without a cardiologist; a plan in San Diego Country that fails to offer a single pediatric cardiologist.
It’s no wonder that Obamacare is unpopular. And we should expect it to become more so as more Americans are forced into Obamacare plans and see more of Obamacare’s actual effects. Women were told to celebrate their savings from the law’s contraception mandate and its regulations on insurance pricing, but that will be hard to remember as such “savings” are swallowed up by massive premium and deductible increases created by Obamacare’s many other mandates and regulations.
Women deserve a better health-care system than what Obamacare offers. Policymakers interested in health-care that works for women should have flexibility as their watchword. Those who want narrow networks should be able to purchase plans that include them, but the government should not rig the market to favor such plans. Women should be free to choose from a wide variety of insurance policies that meet their families’ specific needs and preferences. Health-insurance markets should as much as possible be driven by the desires of patients, not the commands of regulators. That’s the way we make improvements in most areas of American life, and we should try it in health-care too.