Many hospitals excluded in Obamacare, children overlooked - | WBTV Charlotte

Healthcare law promises coverage for everyone, but not everywhere

Health provider networks under the Affordable Care Act could exclude some of the best hospitals in the country. (Source: Broder Medicine) Health provider networks under the Affordable Care Act could exclude some of the best hospitals in the country. (Source: Broder Medicine)
  • National politicsNational politicsMore>>

  • EU lawmakers to press Zuckerberg over data privacy

    EU lawmakers to press Zuckerberg over data privacy

    Tuesday, May 22 2018 5:52 AM EDT2018-05-22 09:52:37 GMT
    Tuesday, May 22 2018 12:04 PM EDT2018-05-22 16:04:51 GMT
    (AP Photo/Andrew Harnik, File). FILE- In this April 11, 2018 file photo, Facebook CEO Mark Zuckerberg pauses while testifying on Capitol Hill in Washington. Tech moguls Bill Gates and Zuckerberg are teaming up to help develop new technologies for kids ...(AP Photo/Andrew Harnik, File). FILE- In this April 11, 2018 file photo, Facebook CEO Mark Zuckerberg pauses while testifying on Capitol Hill in Washington. Tech moguls Bill Gates and Zuckerberg are teaming up to help develop new technologies for kids ...

    Facebook CEO Mark Zuckerberg faces senior European Union lawmakers later Tuesday to answer questions about a scandal over the alleged misuse of the data of millions of Facebook users.

    More >>

    Facebook CEO Mark Zuckerberg faces senior European Union lawmakers later Tuesday to answer questions about a scandal over the alleged misuse of the data of millions of Facebook users.

    More >>
  • The princes, the president and the fortune seekers

    The princes, the president and the fortune seekers

    Tuesday, May 22 2018 12:13 AM EDT2018-05-22 04:13:57 GMT
    Tuesday, May 22 2018 12:04 PM EDT2018-05-22 16:04:19 GMT
    (AP Photo/Evan Vucci, File). FILE - In this May 20, 2017, file photo, President Donald Trump shakes hands with Saudi Deputy Crown Prince and Defense Minister Mohammed bin Salman in Riyadh. In emails obtained by The Associated Press, George Nader claims...(AP Photo/Evan Vucci, File). FILE - In this May 20, 2017, file photo, President Donald Trump shakes hands with Saudi Deputy Crown Prince and Defense Minister Mohammed bin Salman in Riyadh. In emails obtained by The Associated Press, George Nader claims...

    A top Trump fundraiser and a senior adviser to a UAE crown prince ran a secretive campaign, trading lobbying against Qatar for defense contracts from Gulf countries.

    More >>

    A top Trump fundraiser and a senior adviser to a UAE crown prince ran a secretive campaign, trading lobbying against Qatar for defense contracts from Gulf countries.

    More >>
  • Congressional leaders to review information on Russia probe

    Congressional leaders to review information on Russia probe

    Tuesday, May 22 2018 12:12 AM EDT2018-05-22 04:12:21 GMT
    Tuesday, May 22 2018 12:03 PM EDT2018-05-22 16:03:54 GMT
    (AP Photo/Carolyn Kaster, File). FILE - In this Thursday, May 17, 2018, file photo, U.S. President Donald Trump speaks during a meeting in the Cabinet Room of the White House, in Washington. Trump said he will "demand" that the Justice Department open ...(AP Photo/Carolyn Kaster, File). FILE - In this Thursday, May 17, 2018, file photo, U.S. President Donald Trump speaks during a meeting in the Cabinet Room of the White House, in Washington. Trump said he will "demand" that the Justice Department open ...

    The agreement came after President Donald Trump made an extraordinary demand that the Justice Department investigate whether the FBI infiltrated his presidential campaign.

    More >>

    The agreement came after President Donald Trump made an extraordinary demand that the Justice Department investigate whether the FBI infiltrated his presidential campaign.

    More >>

(RNN) - One of the many growing pains related to the Affordable Care Act could be the effect on hospitals whose focus is treating low-income patients and those without insurance.

The majority of healthcare facilities in the United States - more than 3,500 - receive tax-exempt status because they are public institutions that spend a specified percentage of their revenue on people who cannot pay for healthcare; or they were created as charitable arms of religious organizations.

Federally mandated healthcare for all citizens means that pool gets shallower, making it more difficult for a hospital to claim a sizable portion of its operating expenses that goes toward "charitable healthcare."

The goal is to ease the government's financial burden by replacing federal subsidies with more payouts from health insurance companies.

However, the process of selecting providers under the new law is raising concerns.

A recent New York Times report found insurance companies in many states were passing over a large amount of hospitals, especially those that primarily provide care for poor and chronically ill people.

Insurers say a narrower selection of providers helps keep costs down for consumers, something health experts have debated.

"Children's hospitals, research and teaching institutions - they tend to be more expensive," said Jim Kaufman, vice president of policy for the Children's Hospital Association. "If an insurance company is looking mainly at cost, that's a major concern for us."

Another tradeoff to a limited amount of healthcare providers is that patients could have to travel a greater distance for treatment.

The Health Research Institute of PricewaterhouseCoopers released a study that said "the use of narrow networks may also lead to higher out-of-pocket expenses, especially if a patient has a complex medical problem that's being treated at a hospital that has been excluded from their health plan."

Some of the most glaring examples of insurers excluding major medical centers, the study said, were in California, Illinois, Indiana, Kentucky and Tennessee.

Blue Cross Blue Shield in Tennessee created a new network that would not pay for treatment at several hospitals in the state, including world-renowned Vanderbilt University Medical Center, according to TV station WSMV.

But what about the kids?

An unintended consequence of the Affordable Healthcare Act could be its effect on medical care for children.

There will not be many young people enrolled in state healthcare exchanges because the majority of them are already eligible for coverage through Medicaid or the Children's Health Insurance Program (CHIP).

But that could change sooner rather than later.

States have the option to cover more children through Medicaid expansion, but nearly half are either opposed or on the fence about the issue.

Funding for the CHIP program ends this year, and if it is not reauthorized, those children could get rolled into healthcare exchanges.

There is one major problem with that - the exchanges are not child-friendly.

According to Kaufman, the benefits packages focus more on wellness and prevention than things like habilitative care. Habilitation - as opposed to rehabilitation - teaches functional motor skills to children at a later stage in life. They may never have had those skills early on because of what their disabilities prevented them from doing.

"Children continue to grow, so some things need to be modified," Kaufman said. "Healthcare is very, very complex. I don't think it's intentional. People focus on what they know and understand, so it's focused on adults."

Even in the current system, many children covered by Medicaid have a hard time receiving healthcare because of the number of providers that do not accept that form of insurance.

Expanding the program does no good if hospitals and doctors are not included in networks or if they never accepted Medicaid in the first place.

"We'll be the first to tell you there are a lot of great things about our healthcare system, but there are also a lot of things that need improvement," Kaufman said. "Is it going to solve the federal deficit? No. But it will improve care coordination for families and help save some costs."

Copyright 2013 Raycom News Network. All rights reserved.

Powered by Frankly