California health insurance exchange still lacks doctor search tool
Several days into enrollment, California’s insurance exchange still has no answers for people wanting to know if their doctors are included in health plans being sold on the state-run market.
Covered California, the state’s new insurance marketplace, said Thursday that its online search tool for doctors and hospitals won’t be ready until Monday at the earliest.
The exchange touted the feature when enrollment began Tuesday, but it has run into repeated delays amid other computer problems that have bogged down enrollment.
Many people are worried about holding on to their current physicians with the federal healthcare law creating so much industry upheaval. The California Medical Assn., which represents about 37,000 doctors statewide, has expressed frustration about the delay in disclosing the provider information.
The issue is especially important because many insurers in California have sharply limited their number of doctors and hospitals to help hold down premiums in the exchange. That has fueled concerns that some patients may struggle to get the care they need.
Mark Sande, a 58-year-old actor in Los Angeles, said he and his wife want to know the status of their physicians before picking a new plan in the exchange. They pay about $750 a month for a high-deductible policy now.
“We’ve been going to the same doctors for years and years,” he said. “I would definitely check before I sign up.”
Sande said he hasn’t been able to get that far because of persistent error messages on the state website at www.coveredca.com. He said he successfully created an account Tuesday, the first day of enrollment, but hasn’t been able to log in to go shopping despite a dozen tries in the last three days.
“I understand that rolling out a new and busy site is a glitch-prone process, but it’s been very aggravating,” Sande said.
Covered California officials say some glitches are inevitable in launching such a complex program, and they said Thursday that the website’s performance is improving. The state said the delay in installing the medical provider directory occurred because technical resources were shifted to keeping the website operational during the first few days of heavy traffic.
Exchange officials agree that the provider search tool is of vital concern to many patients and say that’s why it has remained a top priority.
“People care about this and they want to know, ‘Is my doctor in the network?’” said Peter Lee, executive director of Covered California. “We don’t want this to just be about getting insurance. We want people to get the care they need.”
Ted Mazer, an ear, nose and throat surgeon in San Diego, said the state erred in not having information on medical providers available when the exchange opened.
“It’s a little late to sign people up and then tell them who they can see,” Mazer said. “We don’t want a bait and switch.”
California’s exchange wants to enroll more than 2 million people into health coverage by the end of next year, the most of any state.
Consumer groups say there’s still plenty of time to iron out problems before consumers have to make a decision. People must enroll by Dec. 15 to have coverage that starts Jan. 1. Enrollment in the exchange runs through March 31.
“Just as consumers don’t purchase a car on the first visit to the lot, we expect that people may shop and think about their options for a bit before buying,” said Anthony Wright, executive director of Health Access, a consumer advocacy group. “The ability to quickly search for what health plans include your doctor or local hospital is a powerful new tool for consumers.”
Wright said the narrow networks in the exchange shouldn’t keep people from getting needed care if state regulators enforce rules on “timely access” to care.
The California Medical Assn. and other physician groups have been asking the exchange for details about the health plan networks for months. They say they wanted more time to review the provider lists for any errors and to gauge whether the insurance networks were adequate before the information was handed over to consumers.
Some physician groups are also skeptical of the state’s claim that its health plans will cover about 80% of California physicians, given the wide use of narrow networks.
“Without the network directories, we really don’t know. It’s guesswork,” said Lisa Folberg, a vice president at the California Medical Assn. “We want to make sure consumers have all the information they need to make the best decisions about their insurance.”
In the meantime, Covered California says consumers can check with health plans directly to ask about participating doctors and hospitals. “We would prefer people not have to make that extra step, and hopefully we will clear that up by Monday,” exchange spokeswoman Anne Gonzales said.
Some insurers, such as Blue Shield of California and Anthem Blue Cross, have updated their online directories to reflect the new exchange networks. Blue Shield says exchange customers will be restricted to about half of its regular physician network.
“Keeping a provider directory up to date is a huge challenge with tens of thousands of doctors under contract,” Blue Shield spokesman Steve Shivinsky said, “and the exchange has just added another layer of complexity.”
Your guide to our clean energy future
Get our Boiling Point newsletter for the latest on the power sector, water wars and more — and what they mean for California.
You may occasionally receive promotional content from the Los Angeles Times.