Way #9: Doctor Choice and ER Access
Some of the significant health care reforms are the simple things – like being able to choose your primary care provider, or not worrying about out-of-network fees when you’re away from home and have to go to the emergency room. Those reforms are part of the rights and protections now guaranteed by the Affordable Care Act (ACA).
As a healthy young woman, I don’t often have to go to the doctor, but I do need to see an OB-GYN on a semi-regular basis. The ACA removed an irritating impediment to my access to the health care I need most by making it unnecessary for women like me to get a referral from our primary care provider just to see our OB-GYN specialist. That extra visit or call to get “permission” may have hampered our access to the preventive care we really needed from the OB-GYN, and that unnecessary step took the valuable time of primary care doctors, when we really didn’t need to see them. This is a benefit I hardly recognize anymore, but it makes sense and streamlines access to health care. Parents can also select any available participating primary care provider for themselves, and pediatrician primary care provider for their children.
Another reform that just makes sense is not having to pay out-of-network fees for emergency room services. When you’re out of town and need to go to the ER, you need to go to the ER. You don’t have time to get home to your plan’s network of preselected emergency health care providers, or call for prior approval before going out network. Prior to the ACA, many plans would limit payment for out-of-network emergency services, charge higher co-payments, or require prior approval. Now, those concerns are a thing of the past. You can focus on getting the emergency care you need, when you need it, wherever you are.
Simple thing like doctor choice and access make a big difference. And we’re already benefiting, thanks to health reform.
Sara Eskrich
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As we wait anxiously for the Supreme Court to issue their decision on the Affordable Care Act (ACA), we know that children and families in Wisconsin are already benefiting from the law. It is important to recognize these ways in which the ACA is already making an impact and what could be lost if the Court strikes down the whole law. This is one in a series of blog posts highlighting what we think are the top ten ways children and families in Wisconsin are already benefiting from the health care reform law.
