Wednesday, July 13, 2016

DPC in Tennessee

As a longtime proponent of the Direct Primary Care (DPC) movement, I found this article quite disappointing.

First, let's start with the fact that a state legislature can't change Federal law. So the fact that The Volunteer State has passed the Healthcare Empowerment Act may well be a great thing, but doesn't change the fact that the ObamaTax is the law of the land, including Tennessee:

"The bill states that DPC arrangements are not health insurance, and are not regulated by the Department of Commerce and Insurance."

How a given state chooses to regulate its citizens and industries is, of course, entirely their choice, but the ACA has specific verbiage relating to DPC, and these aren't open to state by state interpretation.

In this case, the ACA explicitly states that the "Secretary of Health and Human Services shall permit a qualified health plan to provide coverage through a qualified direct primary care medical home plan that meets criteria established by the Secretary, so long as the qualified health plan meets all requirements that are otherwise applicable and the services covered by the medical home plan are coordinated with the entity offering the qualified health plan."

The next item with which I have issues is this:

"If you have primary care coverage through your insurance but also sign up for DPC, are you paying for coverage twice? Technically, yes."

Um, there's no "technically" about it: you're going to pay both the DPC fee and the insurance premium (if you want coverage for the oncologist, ER doc, cardiologist, etc). Now, I don't actually have a problem with this: it's the price one pays for accessing the DPC model. There are a lot of benefits to that model, to which the article alludes; I just don't understand why the author found the weasel wording necessary.

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