<p>Your state officials, that is. Which is why some of us suggest you complain within your state.</p>
<p>GP, jeez. I guess I have to spell it out. </p>
<p>Anthem AND OTHER INSURANCE COMPANIES have decided, for whatever reason, not to make sure their lists are accurate and their networks adequate. This is THEIR decision. Nothing in the law makes them do this; in fact, the law prohibits this. You cannot blame ACA for the fact that Anthem AND OTHER INSURANCE COMPANIES are not following the law. (Well, I’m sure you can, but reasonable people will not. )</p>
<p>And yes, our state insurance commissioners must be held accountable too in November.</p>
<p>ER Visits rise according to article in the WSJ:</p>
<p>
</p>
<p><a href=“http://online.wsj.com/news/articles/SB10001424052702304422704579574390961658638?KEYWORDS=ER+visits+rise&mg=reno64-wsj”>http://online.wsj.com/news/articles/SB10001424052702304422704579574390961658638?KEYWORDS=ER+visits+rise&mg=reno64-wsj</a></p>
<p>You can certainly blame the state for not enforcing the laws. One has to question why they aren’t doing this. They know the lists are inaccurate and they know the networks have too few doctors. My suspicion is that (particularly with the narrow networks), the state doesn’t want to do anything that would result in increased premiums. Increased premiums will drive consumers away and scuttle the whole mess. </p>
<p>Meanwhile the man in the article needs to start a class action lawsuit against Anthem, similar to the one filed against Blue Shield. </p>
<p>If a person pays premiums and then can’t find a doctor, at minimum they should get their money back.</p>
<p>The insurance companies aren’t doing anything without the tacit approval of the states and the federal govt. These substandard networks are an intentional by-product of Obamacare. There are generally few coincidences in life.</p>
<p>I’m not a fan of lawsuits. I agree with conservatives that lawsuits are expensive and cumbersome for everybody involved, lawyers scoop up a lot of the money, a lot of times injured parties don’t get adequately compensated, and sometimes undeserving plaintiffs get a windfall.</p>
<p>But if the insurance companies don’t obey the law, and regulators don’t do their job and make the insurance companies obey the law, then what is left but to go to the courts?</p>
<p>“then what is left but to go to the courts?”</p>
<p>Repeal the law or at least change it </p>
<p><a href=“Fresno woman claims issues with Covered California health insurance - ABC30 Fresno”>Page Not Found | abc30.com - ABC30 Fresno;
<p>This is becoming a big issue.</p>
<p>Doesn’t matter what you do to the law if it’s not enforced. Networks were already narrowing and provider lists were already bad before the ACA.</p>
<p>“Networks were already narrowing and provider lists were already bad before the ACA.”</p>
<p>Absolutely incorrect. CF, unlike you, I was in the individual market for 22 years and the networks were not a problem. Like I said before (ad nauseam), I could go to pretty much any doctor or hospital in the US before Obamacare. Please get your facts right before commenting about the law.</p>
<p>So, the woman in acting’s post was on the radio this afternoon saying she called nearly 50 specialists who all told her they didn’t take Covered CA or Obamacare. Meanwhile, her tendons were shrinking and the ER told her she needed surgery, stat. Yes, this is very much a new ACA related problem.</p>
<p>And since you were the only person in the entire United States who had any kind of health insurance, if it didn’t happen to you it didn’t happen, GP? Oh wait:</p>
<p><a href=“Sitemap - Managedcaremag.com”>http://www.managedcaremag.com/archives/1202/1202.narrow_networks.html</a>
</p>
<p><a href=“http://www.commonwealthfund.org/publications/blog/2014/feb/narrows-networks-boon-or-bane”>http://www.commonwealthfund.org/publications/blog/2014/feb/narrows-networks-boon-or-bane</a>
[quote]
The narrow network strategy emerged long before the ACA, during the managed care era in the 1990s, and insurance companies and large, self-insured employers have used narrow networks ever since to control health care costs. In fact, for the first time, the ACA creates new consumer protections requiring that insurers provide a minimum level of access to local providers. A number of states have exceeded these federal standards using their discretion under the new law.</p>
<p>"Last week, Action News told you about a young woman who was unable to see a doctor despite having a health insurance plan through Covered California. Haley Green, 26, was able to get surgery on her hand and is recovering. She had a severed tendon in her hand and couldn’t see an orthopedic specialist until more than a week later. "</p>
<p>I know some interesting, odd details about hand/wrist tendons. </p>
<p>But was her surgery covered or did she have to pay out of pocket?</p>
<p>She’s another potential plaintiff in a suit against the insurers.</p>
<p>This woman couldn’t find an OBGYN in Fresno until she was 5 months pregnant and then it was not through her insurance. </p>
<p><a href=“Covered California enrollee claims issues finding doctor - ABC30 Fresno”>Page Not Found | abc30.com - ABC30 Fresno;
<p>So much more could have been done if a tenth of the money spent on ACA had been spent on educating and training more doctors. </p>
<p>I’ve been poking around, in anticipation of Mr. Fang’s retirement next month, figuring out what to do about our health insurance. Looks like Mr. Fang and I will stay on Cobra for now anyway, but Fang Jr. will buy a somewhat subsidized Kaiser plan on the exchange. Kaiser should work well for him.</p>
<p>…sigh…</p>
<p>CF: IMO it is our first and foremost obligation is to take care of ourselves and our family…those we chose to create and promised to support…remember…put on your own oxygen mask before attempting to assist those around you. So FWIW, I applaud your decision to do just that.</p>
<p>However, you must recognize the irony of someone who has been an adamant and vocal supporter of the philosophical goal and intent of the ACA to state …‘well…it’s good for THEM…but I’m going to avoid the whole mess as long as possible with all the personal $$ I can throw at it…but thanks for the offer anyway’. In the end, the lofty goal of ‘for the good of others’ really does become subservient to the healthy and ingrained drive to take care of the needs of one’s own BEFORE those of others.</p>
<p>Choosing COBRA proves that point.</p>
<p>Either way, Mr. Fang and I can see all our doctors, and go to all the hospitals around here. That’s not a worry. So it comes down to which is cheaper. It looks like COBRA will be cheaper. If it isn’t, we’ll buy a private policy either on or off the exchange. (But not from Anthem. Doesn’t matter how cheap Anthem is, we’re not buying an individual policy from a company with the worst customer service on the planet.)</p>
<p>But Fang Jr. will go on the exchange. Isn’t that good enough for you?</p>
<p>Historically COBRA has been way way more expensive than either individual or small group coverage. If in fact COBRA less expensive and more attractive than either individual or small group plans that says volumes about the effect of ACA on health insurance costs.</p>
<p>But of course by going with COBRA you are avoiding participation in the risk pool that truly needs your funding source.</p>
<p>
</p>
<p>Not for people our age, for the similar coverage! COBRA is just the amount the employer was paying for the employee’s insurance, including the employer part and the employee part. The premium is not age-rated; it’s the same for all the 23-year-olds at Mr. Fang’s company as it is for him. So the young people at Mr. Fang’s company are subsidizing the old folks like us (thank you, young hotshots).</p>
<p>If individual premiums were not age rated, they too would be a lot cheaper for the parents in this thread. And they’d be a lot more expensive for our kids.</p>
<p>This makes sense. Mr. Fang’s company really ought to be able to get a better deal buying insurance than a single buyer. And they can. I’m sure they self-insure and just have Anthem (yuck ptooie) to do the administration.</p>