<p>Sounds to me like samiamy’s “examples” are straight out of a “fwd fwd fwd fwd” email. </p>
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<p>Seems that’s not too effective since they are misbehaving yet again. The fines are a bit of a nuisance and not much more. By the time the actual ruling goes into effect a large number of people have been harmed. GP is right, it’s a bunch of chest puffing and growling by dogs who don’t intend to really bite.</p>
<p>Dietz, whether they bite or not, the fact remains that insurers behaving badly is hardly a function of the new law. Anthem of California was harming people, my family included, long before ACA came along. </p>
<p>LasMa: a selling point of the ACA was that we were all now the beneficiary of benevolent agencies overseeing the insurance companies. THEY would be looking out for us. It was to be a warm fuzzy ‘we are loved and cared for’ system. The insurance companies would have to clearly define their products and provide consumers with cross reference charts, they would have to all provide a minimum number of benefits and a maximum OOP max. We, the lowly consumer was now going to be taken care of by Covered CA/ACA etc. So, Anthem behaving badly before ACA is mute and irrelevant since a main force of the ACA was to force them to behave nicely. That adds up to one major ACA fail before one even begins to crunch the basic numbers.</p>
<p>I’ll remind you that we’re not even halfway through year 1. CA officials have just said that they are looking into violations of the law. Shall we give them a chance to act or not? </p>
<p>Benevolent? Maternalistic? Some sudden shift? I didn’t view it that way, at all. </p>
<p>In the article jym linked on the other thread, notice this: “The Georgia Department of Insurance has received about 30 complaints from consumers about marketplace networks being too narrow, a spokesman said. Nearly 230,000 Georgians have enrolled…” </p>
<p>30 complaints? .00013? Either many folks are satisfied or you guys and gals need to get cracking and make your issues known.</p>
<p>The expanded Medicaid program in Ca is a fraud perpetrated by the state on the citizens who qualified for this freebie. This AP article cites many examples of Medicaid recipients unable to get the health care they need despite having Medicaid coverage. Unfortunately, the state doesn’t reimburse the providers a reasonable rate so doctors are dropping out like flies. Since 2013, over 20,000 physicians in Ca have dropped out of the program. When you get something for nothing, most of the time the service is also worth nothing.</p>
<p><a href=“California expands Medi-Cal while continuing cuts - Washington Times”>http://www.washingtontimes.com/news/2014/jun/21/california-expands-medi-cal-while-continuing-cuts/</a></p>
<p>@lookingforward – I actually had the same take on the California numbers – 115 complaints about provider access against Anthem from January to June, 97 against Blue Shield. Out of what? 1.4 million subscribers overall? </p>
<p>Every system has errors in it – if I’m selling widgets, no matter what I do, some widgets are going to be defective. As a widget-manufacturer, I’ll figure out what levels of error I can tolerate – but if I sold a million widgets and 200 were defective, - I’d probably be quite happy with my 99.8% quality control numbers. </p>
<p>Of course for ever complaint there are going to be some consumers who gave up without complaining, and some who resolved their issues but are not entirely satisfied with the resolution – but I still think those numbers are quite low given that it is a rollout of a new program. My guess is that there are probably specific geographic pockets where the problem is more serious – that is, I doubt that the state would get involved if these were all random complaints state wide, but if there is a concentration in a few specific areas it would be more likely to be evidence of some sort of systematic error or malfeasance on the part of the insurance company, as to those specific regions. </p>
<p>Again, despite the horror stories, my own experience with switching doctors under ACA was seamless - found a doctor easily, schedule an appointment for a routine physical within a few days after my initial call, no wait to see a doctor (waiting area at clinic virtually empty when I arrived for a scheduled end-of-day appointment) – doctor & nurse were very nice & professional, etc. Neither BS nor Anthem has ever listed my old doctor as being on the new networks-- and it does appear that the choice to stay out of the BS network rests on that doctor’s shoulders – so no misrepresentations there. So presumably the process would be just as easy for all other Blue Shield subscribers in my region. But I know that Blue Shield has coverage issues in Alameda County, and Dietz has highlighted the issues in Santa Cruz – so this might also be an EPO vs. PPO issue. (I also saw my former, now out-of-network doctor earlier in the year for a minor medical issue, but that wasn’t complaint-worthy because I would not have met my deductible that early in the year in any case, so I would have paid roughly the same under my HSA plan no matter where I went.)</p>
<p>“Blue Shield has coverage issues in Alameda County”</p>
<p>and also in the entire region of Southern Ca.</p>
<p><a href=“Obamacare's Exchanges Fall Well Short of Enrollment Target”>http://dailysignal.com/2014/06/24/obamacare-exchanges-disappointing/</a></p>
<p>The Daily Signal article is spectacularly dishonest. It gives a misleading graphic showing that 38 million people were previously uninsured and eligible for Obamacare, but only about four million of them now have insurance; in fact, reliable estimates (given in the article!) say that four million plus now have insurance from the exchanges and eight million plus are newly on Medicaid. </p>
<p>My favorite silly statement from an article full of them:
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<p>Psst. News flash: the changes in Medicaid enrollment are because of Obamacare. Obamacare expanded Medicaid.</p>
<p>Daily Shield=Heritage Foundation</p>
<p>Lol. I guess they count on their readers not knowing that. But they do, and so that’s intentional deception (AKA lying). Or else they purport to publish a news article when they are ignorant of a key fact. Either way, good job, Daily Signal. </p>
<p>ETA–Even the headline is wildly deceptive. The goal for the first year was 7 or 8 million, not 26 million. </p>
<p>Right, the goal for the exchanges was 7 or 8 million TOTAL, including newly insured plus previously insured. </p>
<p>Right, the goal for the exchanges was 7 or 8 million TOTAL, including newly insured and previously insured. </p>
<p>eb, that explains it. So definitely lying. </p>
<p>So why do these dumb links get posted? </p>
<p>Because they look credible, if you don’t know, for example, that the Medicaid expansion is an integral part of “Obamacare.”</p>
<p>Here’s Gallup: <a href=“After Exchanges Close, 5% of Americans Are Newly Insured”>http://www.gallup.com/poll/171863/exchanges-close-americans-newly-insured.aspx</a></p>
<p>Five percent of all Americans report they are newly insured in 2014, according to Gallup. That comes to 15.6 million people. Moreover, 2.8 percent (8.7 million Americans) say they are newly insured via the exchanges.</p>
<p>I’m guessing that the 8.7 million newly insured via the exchanges includes a lot of people who went to the exchanges and got Medicaid. </p>
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<p>But actingmt, who posted the link, does know that the Medicaid expansion is part of Obamacare. The article is meant for the ignorant and credulous, but actingmt is neither ignorant nor credulous. So the explanation for actingmt posting this deceptive link remains unknown.</p>