Letter: Thomas Lawler, Leesburg

Editor: For residents of Loudoun County, such as ourselves, who purchase individual health insurance plans and are not eligible for federal subsidies, the news we have received about ACA eligible plans for 2018 has been shocking and dismaying.

First, our current health care provider, Innovation Health, will not offer individual health care plans in Loudoun County in 2018, and several other major health care insurers also exited this market. Second, the two remaining health insurers offering ACA-eligible coverage in Loudoun for 2018 increased their premiums by a huge amount for 2018, enough so that for slightly worse coverage we will have to pay more than 50 percent more next year than we are currently paying. Third, the only companies offering individual health insurance plans in Loudoun County are either a HMO or an EPO (Exclusive Provider Organization), and neither my or my wife’s current primary doctor is in these plan’s networks. And fourth, the nearest major hospital to where we live, Inova Loudoun Hospital, is not “in network” for either available ACA eligible plan, and the closest in-network hospital—Reston—is not even in Loudoun County.

I got a letter from Inova’s chief medical officer reminding me that Innovation Health will no longer provide individual health insurance policies in Loudoun County, and the letter said that only CareFirst BC/BS and Anthem BC/BS were accepted at Inova facilities. What was shocking about this letter was that it did not say that neither of the plans Inova accepts offers individual ACA eligible health insurance plans in Loudoun County.

We are pretty well off, and we can tolerate and manage a huge increase in our health insurance premium. But what seems intolerable, however, is not just that we will have to change doctors, but that there is no Loudoun County hospital that will “accept” any ACA insurance available to us.

Thomas Lawler, Leesburg

8 thoughts on “Letter: Thomas Lawler, Leesburg

  • 2017-11-14 at 9:54 am

    Your (all of ours actually) issue was all part of the plan from the very start Mr. Lawler. But never fear, because all of the new and old democrats in Richmond are going to fix it for you. Folks like Jennifer “it’s not a Medicaid expansion,” before it was Medicaid expansion, Wexton, and Doctor Ralphie are going to push you and the Mrs. right on to, you guessed it… Medicaid. You’re going to love the increased taxes and decreased care.

  • 2017-11-14 at 11:26 am

    “Inova’s mission is to improve the health of the diverse community it serves. We are committed to meeting the healthcare access needs of our patients and their families with the physicians, clinicians and facilities they prefer. The 2018 Healthcare.gov exchange has significant changes for residents of Northern Virginia. In many ways these changes limit options for our patients and their families as some insurers left the exchange, and in these cases, Inova will no longer be offered as an in-network provider, but an out-of-network provider. Of course, emergency services are always available. For those seeking individual insurance options on the 2018 Exchange and desire Inova as your in-network provider, contact your insurer of choice for details.”

  • 2017-11-14 at 5:35 pm

    Folks need to understand what Inova Loudoun Hospital being an “out of network” provider for people who have to buy individual ACA eligible health insurance means. What it means is that, save for emergency room needs, the costs of any”regular” hospital services provided by Inova Loudoun Hospital to Loudoun County residents who have to purchase individual health insurance will not be covered by their insurance, and if such residents want hospital services that will be covered by their insurance, they will have to go to Reston Hospital. I don’t fully understand why Inova Loudoun Hospital is not an in network provider for the few remaining individual health care plans available to Loudoun County residents who have to purchase individual health insurance, but it is clear that for whatever reason Inova Loudoun Hospital is NOT meeting the needs of all of Loudoun County residents, and that is said.

  • 2017-11-15 at 8:10 am

    You can thank President Trump and Congress for doing everything they can to maximize instability in the insurance markets so their “predictions” that what you’re seeing will come to pass. They know well how insurance markets work and are counting on the ignorance of the general population as cover for their insouciance.

    You can also thank the Republicans in Congress over the past 8 years for ensuring that time was squandered rather than assessing and adjusting the legislation to work out its kinks and better serve our country.

    You can see this willful destruction continuing in Mr. Manthos’ unfortunate rhetoric as he takes some glee in your misfortune. It’s that “well, I’m okay, so I really don’t care what happens to you” attitude that is particularly caustic. That’s why Congress refuses to take their own medicine as well.

    Those of us who believe our country is better served with authenticity, realistic rationality, and compassion for all our neighbors are finally understanding that we must each become part of the solution, and we are doing what we can to steer this ship back to virtue. Our primary voice is our vote, and that is a-rising.

    That people like Mr. Manthos feel it necessary to lash out at our local officials about this is a gratifying sign of their discomfort.

  • 2017-11-15 at 9:35 am

    You can thank your president for eliminating CSR’s as one reason insurers leave markets and premiums go up. If he gets his wet dream of eliminating the individual mandate your rates will go through the roof even faster.

  • 2017-11-15 at 2:34 pm

    I’m in the same boat as everybody else RDJ. Rates go up, services go down. Ain’t it great? We’re all so gleeful. And your answer is: we should all have mediocre health care because it’s “compassionate?”

    Where was your compassion when I lost my long term Doctor? And then lost the one after him? Where was your compassion RDJ when my employer stopped providing healthcare — long before Trump — because the cost exploded? Where was your compassion to the millions of people forced off their healthcare plans, and into the “exchange” oblivion? They don’t matter to you, do they? They already had theirs, so who you just gives us the ole’ universal hand signal. Party First!

    The entire Obamacare system was built on lies; “if you like your doctor and your health plan, you keep them, Period!” It was intended to fail from the start, and you know it. Don’t play dumb, because you’re not dumb. Obamacare was a disaster long before Trump ever was a thought in anyone’s minds. And you know it.

    Giving away tax money to big insurance companies without congressional appropriation is about as unconstitutional as it gets. And you know it.

    Senator Wexton lied on the very pages of this newspaper when she tried to sell medicaid expansion as NOT medicaid expansion, the very same week Gov. 47% told an audience at INOVA Loudoun, that it was…. Medicaid expansion. And you know it.

    Are you on Medicaid RDJ? I bet not. Could it be you’re on generous public employee funded system? You got yours, so who cares about the rest of us, right? Who cares about Mr. Lawler and every one else getting the screws from the fraud that is Obamacare. You’re good with it.

    You’re hardly in a position to lecture anyone about “virtue”or “realistic rationality” and most particular “authenticity.”

    Mr. Lawler’s letter is a voice reaching out to call attention to the massive punch in the face we’re all about to get thanks to Obamacare and spineless republicans, while all you bring to the table is deflection and cover-up. I always thought better of you.

    You got one thing right: Congress should of eaten from the crapsandwich they made for us. At least we agree on something.

  • 2017-11-15 at 2:34 pm

    Health insurance has become an 8-year debacle. Obamacare killed off my previous private plan and I wasn’t happy about it. I was also on the Innovation Health plan for about 6 weeks. I never used it, but the crazy thing was that I couldn’t get rid of it. NONE of the contact numbers worked at all and, unlike regular insurance, you just keep getting bills if you don’t pay (usually, they just drop your coverage). It was such a headache. Glad I don’t use it any more.

    My shot at Obamacare aside, I just wish our federal government could solve a problem. In particular, I wish they could agree on a stable system and then just back away and leave the market alone. 8 years of a complete screw up is more than enough.

    Thank you Mr. Lawler for making the public aware. I hadn’t heard anything about this but it is a very concerning issue at a local level. It would be nice if the various health companies would just state in plain english what the problem is.

  • 2017-11-27 at 5:01 pm

    Your own presumptions seem to have blinded you, Mr. Manthos. In the case of me:

    “Are you on Medicaid RDJ? I bet not. Could it be you’re on generous public employee funded system? You got yours, so who cares about the rest of us, right? Who cares about Mr. Lawler and every one else getting the screws from the fraud that is Obamacare. You’re good with it. You’re hardly in a position to lecture anyone about “virtue”or “realistic rationality” and most particular “authenticity.””

    No, I am not on Medicaid, nor do I receive any “generous public employee funded system”. I’ve had insurance through my employer for the majority of my career with the exception of a few years when I was an employee at Virginia Tech back in the 1980s. Your trying to paint me as being somehow “on the dole” is laughable, but worse, it demonstrates how readily you look down on your fellow man.

    Medical costs have risen continuously over the past few decades, and employers have scrambled to keep up with increasing costs, because they have to pay part of those health insurance premiums to remain competitive. Instead of responding to the realities of this increased cost of doing business by pressuring Congress to do something about the cost side of the medical care equation, they have chosen to erode benefits for their employers. In other words, so long as they can dilute coverage for their employees and avoid reducing profits going to upper management and shareholders, they’ve been just fine with things as they are.

    Who’s been left out to dry? People who don’t have health benefits as part of their employment or who don’t have jobs at all. That was a problem long before President Obama took office. He did not cause that. The ACA was an initial effort to address that issue. It did not go far enough, nor was it adequate to solve that problem. But rather than continue refining it or beginning to address the cost side of the equation, the GOP throughout two terms of the Obama Administration chose to choke any and all progress. And… here we are.

    That’s not deflection, it’s just the application of some logic.

    For you to focus entirely on Obama as the sole cause of your woes makes just as much sense as what the GOP has had to say for all these years they’ve not done their jobs to fix any of this – not on the insurance side and not on the cost side, either – and, as we’ve seen in the past 11 months, continue not to do it.

    I’m sorry you endured the inconvenience and frustration of having to switch doctors. As I’m sure you know, the health care marketplace is highly complex and has remained part of the free market throughout this timeframe. How could President Obama have lied about something we all knew he could not control? And why are you still discussing what he said 7 years ago? What has the current president or Congress done to fix any of it?

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