In just four months of operation, the new Covered California state health exchange has received about 1,500 complaints from consumers, reports the Los Angeles Times.
The complaints focus on everything from basic plan enrollment confirmations to inaccurate provider lists and small, insufficient physician networks, according to the California Department of Managed Health Care.
Many of the complaints seem to center on frustration with access to care. Breitbart News recently reported that two San Francisco residents sued BlueShield over alleged misrepresentation of the size of BlueShield’s physician network on the company’s website.
In fact, BlueShield received the second-highest number of complaints, 461, out of all health insurers in the state, and 17% of those complaints were about finding in-network doctors, according to the report. Anthem BlueCross, the largest health insurer in the state, had 658 complaints, and 13% were about insufficient care provider networks. The complaints were filed between January 1 and Aril 30.
Insurance companies and Covered California officials are reportedly “working hard” to solve the problems, but California Department of Managed Health Care spokeswoman Marta Green acknowledged the predicament some patients find themselves in.
“If you have a medical condition and can’t get care, that is a very serious issue. We are still working to resolve many of these cases,” Green said in the report.
“These complaints are one indicator we are looking at for the scale and scope of the problem,” Covered California executive director Peter Lee said in a statement. “We want to ensure the networks are adequate.”
Charles Bacchi, executive vice president of the California Association of Health Plans, tried to spin the problems of misrepresentation and small physician networks in a positive way in the report.
“Some networks are very broad and others are more selective — giving consumers the option of choosing a plan that may have fewer providers but costs less in monthly premiums,” he said.
On Thursday, Covered California officials commended some health insurance companies for increasing the size of their networks over the past few months in an effort to handle increased demand. Anthem BlueCross reportedly added 3,800 care providers to its statewide network since January, and BlueShield’s individual coverage PPO network now includes 62% of doctors and about 80% of state hospitals.
According to the report, Covered California estimates that 1.2 million people signed up in the six-month enrollment period, “assuming 85% of consumers pay their premiums,” an assumption the exchange probably should not make.
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