KU Health strikes deal with Obamacare insurer; other providers still not covered

University of Kansas Health System patients covered by the Affordable Care Act, commonly known as Obamacare, can breathe a little easier today.

The health system, home to the largest hospital in Kansas City, announced Wednesday that it had reached a deal with Ambetter, one of the insurance companies selling Obamacare plans in the area.

Adding KU to the Ambetter network two weeks into the open enrollment period means thousands of patients covered under the Affordable Care Act now have an option other than paying out of pocket or finding other doctors.

“We understand this situation has been challenging for patients and their care teams,” KU Health said in a statement released Wednesday.

“We are committed to the care and well-being of our patients and look forward to being able to continue to serve them through our partnership.”

Blue Cross and Blue Shield of Kansas City decided not to sell individual insurance plans for 2018 through Obamacare, citing financial losses. That left thousands of people on both sides of the state line looking for a new insurer.

Medica and Ambetter are selling plans on the Kansas side and Cigna and Ambetter are selling them on the Missouri side.

Blue KC’s Obamacare exit affects only Kansas consumers in Wyandotte County and Johnson County. The other 103 counties are covered by Blue Cross and Blue Shield of Kansas, which is still selling ACA plans.

KU Health said it was notifying patients of the change and providing instructions on how to enroll in an Ambetter plan.

The plans available now have narrower networks than Blue KC’s, even with the addition of KU Health to Ambetter. Major medical providers like Shawnee Mission Health and Olathe Health, as well as Courtney Eiterich’s neurologists at College Park Family Care, still aren’t covered by any of the available plans.

Eiterich, from Lenexa, has had multiple sclerosis for about 10 years.

“I just feel like I shouldn’t have to change doctors who know me and know my case,” Eiterich said. “They’ve been my doctors forever.”

Eiterich said her doctors told her they’re still in negotiations with Ambetter about entering their network she’s “just holding out to see what happens.”

Kari Ann Rinker, the senior manager for advocacy for the National Multiple Sclerosis Society in Kansas and Missouri, said the group has heard from other people with MS who are also losing their doctors.

Ken Bacon, the president and CEO of Shawnee Mission Health, said Wednesday that his system is still negotiating with the remaining insurers.

“We want to be in those networks and we’re working to be in those networks,” Bacon said. “We think that it’s better for patient care and it’s better for patient choice for all of us to participate in that. So we’re working towards that as we speak.”

The open enrollment period for Obamacare insurance began Nov. 1 and ends Dec. 15 this year. It’s shorter than in past years, adding more urgency for consumers to sign up so they’re covered in 2018.

“I’d hope they could hang tight because we think we’re close to becoming participants in that network,” Bacon said.

Bob Hanson, a spokesman for the Kansas Insurance Department, said consumers who have already chosen a health plan on the ACA exchange can switch to another during the open enrollment period.

Hanson also said the department has been fielding about 10 to 15 calls a day about ACA enrollment.

“Not all are coming from the Kansas City area,” Hanson said. “However, many of the calls are asking about networks.”

Blue KC’s ACA customers are now being auto-enrolled into other plans for 2018. Eiterich got an email from Ambetter welcoming her to that company’s plan and urging her to “Make your premium payment by December 31st, so you can start using your coverage on January 1st!”

Hanson said the insurance department wants consumers to know the auto-enrollments are not final until they pay their first premium. Until then, they’re free to shop around during open enrollment.

But Eiterich, a substitute teacher and small-business owner, said there are no good options for her in the ACA market right now. She and her husband, a software consultant, are looking for other solutions, like finding an employer that offers insurance.

“I’m not going to enroll in a plan that I know doesn’t cover my doctors,” Eiterich said. “So I’ve just been looking around for a full-time job and trying to figure out what I’m going to do.”

This story was originally published November 15, 2017 at 2:37 PM with the headline "KU Health strikes deal with Obamacare insurer; other providers still not covered."