According to a hospital statement announcing the lawsuit:
“Children’s is the only pediatric hospital in King County and the preeminent provider of many pediatric specialty services in the Northwest. Some of these specialized services not available elsewhere in our area or region include acute cancer care, level IV neonatal intensive care and heart, liver and intestinal transplantation.”
Without inclusion of Children’s, current and future patients and families who obtain insurance from several plans offered will not be able to access care at Children’s as an in-network provider. This lack of suitable access to pediatric services means that families enrolled in these plans may not receive the most timely, appropriate care, and face larger out-of-pocket amounts.”
Yesterday, Seattle Children’s PR team went after the Insurance Commissioner full force, distributing a press release detailing the number of children who received care without coverage at Children’s in January, due to their enrollment in the new exchange plans.
Seattle Children’s treated 125 patients enrolled in the exchange plans in the first month since they became effective. I confirmed today with the hospital that theses plans have no out-of-network benefits, meaning the patient is responsible for the entire cost of care — a situation that isn’t so different from being uninsured.
The hospital has filed exception request on behalf of all 125 patients; 20 requests received responses, and 12 were approved. Eight, though, were denied.
As a consumer, I’m in favor of having a variety of low-cost plan options. But for families in Washington that didn’t quality for Medicaid nor could obtain insurance through an employer, their coverage options don’t include Seattle Children’s, even if they were willing to pay more for it. Therefore, if their child is stricken by a rare or complex illness that is best treated by the specialized pediatric providers at the hospital, their only choice is to pay full cost.
To me, that suggests the exchanges’ promise of improved consumerism has fallen significantly short — at least for parents and children in Seattle.