.
11/9/13, "ObamaCare leaves doctors on the hook for deadbeats," Tori Richards, reason.com
"The Affordable Care Act doles out three months
of free health care to individuals who choose to default on their
premiums; providers and insurers pick up the tab."
"Tucked inside nearly 11,000 pages of the Affordable Care Act is
a little-known provision that doles out three months of free health
care to individuals who choose to default on their premiums.
People who receive the federal subsidy to be part of Obamacare
will be allowed to incur a three-month “grace period” if they can’t
pay their premiums and then simply cancel their policies, stiffing
the doctors and hospitals.
Their only repercussion is that they have to wait until the
following year’s open enrollment if they want coverage on the
exchange.
“It will help break the system,” said Rep. Louie Gohmert,
R-Texas, one of a core group of Republicans who oppose Obamacare.
“This is a huge piece of evidence to show this can’t work, you will
break the system and bankrupt people involved.
“The hospitals, doctors and insurance companies will be left
holding the bag. There will be disagreements over who will pay for
what. Lawyers will get involved because we are talking about a lot
of money,” he said.
Under Section 156.270 of
the Affordable Care Act, the insured needs to pay a premium for
just one month before qualifying for the three-month grace period.
The insurance company must pay the claims during the first month of
the grace period; during the second and third month doctors and
hospitals are left to collect unpaid bills.
This loophole wasn’t lost on some unnamed individuals who
queried the Department of Health and Human Services during an open
comment period for the new law in 2011.
While officials at HHS did not respond to requests for comment
on this story, they did offer a glimpse into their thinking in a
March 27, 2012, report
contained in the Federal Register.
“HHS will continue to explore options for incentivizing
appropriate use of the grace period,” the register said. “HHS
will monitor this issue moving forward and will continue to work on
the development of policies to prevent misuse of the grace
period.”
Experts say the federal government has given people the green
light to commit fraud.
“In a sense, it legalizes fraud,” said Wesley J.
Smith, a senior fellow at the Discovery Institute of Human
Exceptionalism and a frequent critic of the Affordable Care Act.
“It legalizes putting your burdens on the insurance companies’
shoulders and never paying your premiums. The government wants
people to be irresponsible and apparently they want the whole
system to descend into chaos.”...
The Texas Medical Association is educating its members about the
loophole and receiving feedback from worried doctors. Many in that
state operate on a shoestring budget, sometimes taking out loans to
stay in business....
The California Medical Association has taken the step of
notifying the American Bar Association about the situation.
“The more nefarious insureds may take advantage of
HHS-acknowledged opportunities to game the grace period and get 12
months of coverage for the price of nine before simply enrolling in
a new plan under (Obamacare’s) guaranteed issue requirements,”
wrote Association associate director C. Brett Johnson.
He chronicled a potentially nightmarish situation for a
doctor:
“For instance, an oncology practice generally purchases the
drugs to be used in a course of chemotherapy up front — which can
run into the tens of thousands of dollars — and is then reimbursed
by the payor as part of the medical service. Costs such as these
are on top of the costs of displacing other patients with
coverage.”...
“You have a president who says doctors are greedy — they do
surgery just so they get the money,” Gohmert said. “That’s what the
president said. That same president will certainly be
willing to say, ‘Greedy doctors are demanding more money – we just
need to have Washington take over all health care.’”
"This article originally
appeared at Watchdog.org." via Free Republic
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Free Republic thread on the above article
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