<p>CF, in my region, one hospital owns all the facilities for a 60 mile radius. I am not sure who has the leverage? My guess is the hospital.</p>
<p>If one hospital chain owns all the facilities for a 60 mile radius it means having more insurance carriers won’t help drive down prices. At least, won’t drive down prices of hospital services anyway.</p>
<p>Yeah… We have an insurance oligopoly vs the hospitals oligopoly. The patients… Kind of out of luck…</p>
<p>My employer just told us that because of the ACA, any employee with a spouse working elsewhere that was permitted to take insurance at that place, must be dropped from our insurance and the spouse must take insurance at that other place.
They also told us our premiums would be going up, though they didn’t yet have an exact figure.
Looks like my premiums won’t be going down 2500 a yr.</p>
<p>Big business rules. They buy the access, they write the laws.</p>
<p>This hospital started buying its competitors around 15 years ago and got the job done in the last 5 years. I actually asked the State Dept of Justice to investigate them for antitrust violations, but the DoJ was asleep at the wheel.</p>
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<p>We’ve already heard of various businesses that take an action “because of the ACA” when it was actually an action to save the business money. Does the ACA require that a spouse of an employee CANNOT be added to the employee’s plan if the spouse has their own employer-provided insurance, or is this just another money-saving plan being blamed on the ACA? (I think the employer is justified in not covering spouses who could get their own insurance, but the employer ought to tell the truth about it.)</p>
<p>^^Agree with CF, it is probably a money saving move on the part of the company, blamed on the ACA. Of course, if a spouse can get coverage at their own company, they are paying their own premiums and deductibles, instead of just adding on to the family policy. If the spouse has a low income, it may be more advantageous for them to quit their job. Kind of pathetic to have to think that way. How can we lower our income to benefit financially.</p>
<p>“any employee with a spouse working elsewhere that was permitted to take insurance at that place, must be dropped from our insurance”</p>
<p>How big is your employer?</p>
<p>A 20 mile drive can take an hour or more in my area, even at non peak traffic times. My closest Kaiser hospital is nearly 20 miles away, for urgent care or ER or hospital services. For specialty services, it can be even further away. </p>
<p>What is realistic for one may not be logistically possible for another. </p>
<p>When we had a PPO, our urgent care facility and doc’s offices were 5-10 minutes away. In a truly urgent situation, convenience and getting quick care are essential. </p>
<p>I honestly hope that we do not ever have a time is of the essence emergency, because it is a slow process getting to the closest Kaiser hospital for us.</p>
<p>SamuraiLandmark, I would check, but in an emergency Kaiser allows it patients to go to the nearest hospital. My daughter went to a non Kaiser hospital in an energency and she was covered by Kaiser. No problem. </p>
<p>Maybe Kaiser is usually the closest hospital to you… But if it isnt… I would find out the rules. I would find out the rules anyway. You never know where you might be.</p>
<p>I believe this is still in effect.</p>
<p><a href=“http://benefits.stanford.edu/cgi-bin/resources/kaiser-coverage-when-traveling-mci-international-access[/url]”>http://benefits.stanford.edu/cgi-bin/resources/kaiser-coverage-when-traveling-mci-international-access</a></p>
<p>My employer is about 200 people at my location, though they have other facilities throughout the U.S.</p>
<p>I also understand the ACA may not specifically mandate what my employer claims is because of the aca. But whether one believes it is a required change or an excuse to make a change, either way it has come about as a result of the ACA. Unfortunately, I had liked the plan I had and wanted to keep it. Period.</p>
<p>Dstark, </p>
<p>Thanks for that info. Good to know. I will have to double check that number and put it in my phone in the event of the unexpected. </p>
<p>We have been lucky that we haven’t had emergency hospitalization - but did have one late night ER visit with a kid which was extraordinarily inconvenient!</p>
<p>GoldenPooch: You asked about the Blue Card & coverage while traveling. I found this on the Blue Shield web site:
<a href=“https://www.blueshieldca.com/bsca/find-a-plan/understanding-insurance/faqs.sp#answer_5[/url]”>https://www.blueshieldca.com/bsca/find-a-plan/understanding-insurance/faqs.sp#answer_5</a></p>
<p>It is possible that is old information that doesn’t pertain to the new plans, but other info on the page has been updated-- so I think it is likely that is the general statement of policy. (They have to pay for emergency care by law in any case, so I think it’s actually in their interest that when you have a medical need while traveling, that you opt to go in-network)</p>
<p>younghoss -here’s an article you might find interesting:
[Employers</a> Trim Health Costs By Cutting Coverage For Spouses : Shots - Health News : NPR](<a href=“Employers Trim Health Costs By Cutting Coverage For Spouses : Shots - Health News : NPR”>Employers Trim Health Costs By Cutting Coverage For Spouses : Shots - Health News : NPR)</p>
<p>relevant points: </p>
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<p>“The surcharge and the concept of a penalty for spouses who choose to opt out of their own employer coverage — that’s not related to the health care reform law at all.”</p>
<p>I have been seeing this part since 2003 on my plan, ever since the prices started skyrocketing. When my spouse was an independent consultant for a few years, I had to certify that the insurance was not available in order to not pay surcharge.</p>
<p>No spouses with their own health care allowed at my company - for many years. Not tied to ACA, just cost cutting. I don’t have a problem with it. Agree with posters above that link is indirect at best. There are enough issues with ACA implementation (and I like the idea!) without “blaming” ACA for this effect.</p>
<p>interesting article, Calmom. It says 88% of employers have no restriction holding back spousal coverage, and only 6% fall in the category like my workplace soon will be, excluding spouses that could get their own insurance. </p>
<p>In any case, I hope readers here will clearly see I have offered no opinion on this issue, but have only reported to this thread what change of policy my employer will be making, and what my employer told me was the reason. I have also not offered an opinion if I fully believe them or not… I have just stated the facts.</p>
<p>the first paragraph you quoted, “Carkeek says…” confirms my second paragraph of post 3472. The extra coverage/fees/costs added on may not make insuring spouses prohibitive, but I suspect it was the catalyst for my company to change its long-standing policy. I can only guess -what-if- the ACA would not have passed, would my employer still be making these changes?</p>
<p>deleted post</p>
<p>“The extra coverage/fees/costs added on may not make insuring spouses prohibitive, but I suspect it was the catalyst for my company to change its long-standing policy. I can only guess -what-if- the ACA would not have passed, would my employer still be making these changes?”</p>
<p>Probably eventually, but the ACA makes a very convenient excuse for companies to do what they wanted to do anyways, right now. I believe it pushed up the timeframe for such changes. You are not alone, of course, this is happening in other companies. A few months ago, UPS pushed about 15K working spouses off their insurance plans, claiming, “Rising medical costs, “combined with the costs associated with the Affordable Care Act, have made it increasingly difficult to continue providing the same level of health care benefits to our employees at an affordable cost,” UPS said in a memo to employees.”</p>