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Obamacare Creates Hurdles for Illinois Patients & Doctors

On January 1st, the major provisions of the Patient Protection and Affordable Care Act took effect. Also known as Obamacare, this expansive piece of legislation seeks to reduce healthcare costs and increase access to healthcare. But as we recently discussed, the potential impacts of the new law are still unknown. Patients initially encountered significant enrollment obstacles, and it appears that the law has created new frustrations for Illinois residents and healthcare providers.

A recent AP article told the story of two Illinois residents that have already experienced problems with Obamacare since the new provisions took effect on January 1st. Dr. John Venetos was scheduled to perform surgery on Chicago resident Sheri Zajcew on January 1st. However, what was supposed to be a routine call to Zajcew’s insurance provider became a much larger ordeal. Dr. Venetos’ office manager spent two hours on hold with Zajcew’s insurance provider trying to determine whether the patient needed prior authorization for the surgery. The office manager eventually gave up and Dr. Venetos performed the procedure without prior authorization.

Dr. Venetos decided to take a risk and provide medical care for Sheri Zajcew and other patients that are unsure of whether they are covered under Obamacare. “We feel it’s the right thing to do,” Dr. Venetos said. “We may end up stuck holding the bag and not getting paid on these claims.” According to the Chicago-area digestive system specialist, there is “tremendous uncertainty and anxiety” among his patients. Healthcare providers are also uncertain as to how the law will impact the medical industry.

Benton, Illinois resident Nancy Pace also spent a portion of her New Years’ Day on the phone with insurance providers. Pace was attempting to contact Blue Cross Blue Shield of Illinois – the state’s largest insurer in the individual state market – to determine whether she and her husband were in fact covered under the plan they had enrolled in through the federal insurance website. The website has continued to suffer glitches since it was first unveiled in October of 2013. Eventually Pace was able to speak with a representative who confirmed that they were covered and provided her with their membership numbers.

Cautious Optimism Surrounds the New Healthcare Law
Under Obamacare, patients like Nancy Pace – who suffered a stroke and has had trouble finding a good insurance plan – should be covered regardless of pre-existing conditions. Likewise, the new law increased the age limit for children covered under their parents’ plan. If all goes according to plan, Obamacare will increase access to healthcare, lower individual costs, and ultimately save the federal government money. But, as they say, “the best laid plans of mice and men often go awry.”

As both patients and healthcare providers adapt to the changes brought about by Obamacare, it is important to remember that you are still entitled to high quality healthcare. If you believe that you have been mistreated by a healthcare provider, contact the Illinois medical malpractice attorneys at Levin & Perconti. Our experienced, dedicated attorneys will evaluate your claim and determine whether you may be entitled to relief. Contact us today for a free consultation.

See Related Blog Posts:

A Changing Business: Hospitals under the Affordable Care Act

Doctor Admits – Malpractice Costs Are Not the Problem