<p>I think you’re going to find Kaiser to be quite a relief. :)</p>
<p>Emilybee, I coulda used your help yesterday communicating with Comcast business over a simple voice greeting staff assignment change. Truly, it was like something outta the old gillam/stoppard movie Brazil ;)</p>
<p>Dstark, maybe you should let the Komen “pink” brigade take on Anthem over the breast exam. Seriously. Fur would fly. They have the PR machine to just bury them. It might be funny to watch, if it weren’t so freaking frustrating. Maybe you could help Anthrm sell 50% fewer plans in your area 
I would like to see such companies suffer natural consequences.</p>
<p>I mean really, someone has to bully the bullies!</p>
<p>Hey Emilybee, maybe you should go visit Dstark and give Anthem a call…</p>
<p>Good luck, LM! </p>
<p>This is a perfect example of something ins companies have been doing forever (adding new providers to coverage) that they still can’t even handle properly or in a timely fashion. This is not an ACA problem it’s simply incomptance on companies part. </p>
<p>Kmcmom, piece of cake. </p>
<p>sorry the ACA didn’t work out for your dstark. In locales where they have a major tertiary hospital, Kaiser care is excellent. (It’s also excellent where they don’t have tertiary hospitals, but you then have to schlep to them, which can be a hassle when you are ill.)</p>
<p>(btw: you can’t say that I didn’t warn you years ago about cost control by service restriction.) </p>
<p>I’m going through the new-doctor-to-the-practice isn’t recognized by the insurance yet even though the paperwork has been signed by the practice and the insurer. (Employer-provided coverage, not ACA marketplace.) I figure it is going to take a couple of months to resolve. Because it always does.</p>
<p>Thanks, but…why are you assuming ACA did not work out for me?</p>
<p>Anthem is not working out. Pre ACA or now. ;)</p>
<p>We got all the care we needed this year. Actually, the care aspect worked out much better. Because of the network restrictions, my wife had to switch doctors and the new doctor was better. He operated on two eyes instead of one. He was also a fraction of the cost compared to the doctor who was out of network. I am comparing in network costs to in network costs.</p>
<p>I recommend Marin Eyes if you need eye care in Marin County.</p>
<p>Anthem can do a better job. It is too difficult to deal with Anthem. Anthem needs to come out with an accurate in network list. It should be easier for patients to find out who is in network. A patient should not have an operation and have to worry who is in network. This is already being fixed in places like NY. This should be fixed everywhere.</p>
<p>One thing I find interesting is how slow Anthem’s response times are right now. My wife’s doctor’s office was on hold with Anthem for 30 minutes before they gave up a few days ago. </p>
<p>And the next start up period is about to start. </p>
<p>Anthem has been a problem for me for over 10 years. Now, with ACA, I can switch every year.</p>
<p>Thanks for the Kaiser info.</p>
<p>“I’m going through the new-doctor-to-the-practice isn’t recognized by the insurance yet even though the paperwork has been signed by the practice and the insurer…”</p>
<p>This should never be a problem. It’s not rocket science, plus adding/subtracting service providers isn’t a new thing either. It should not take months. It should take minutes. It’s purely incompetence on the part of the insurance companies. </p>
<p>Eb, right, it has nothing to do with ACA and everything to do with inefficiency. </p>
<p><a href=“http://hosted.ap.org/dynamic/stories/U/US_SUPREME_COURT_HEALTH_OVERHAUL_SUBSIDIES?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2014-11-07-12-51-59”>http://hosted.ap.org/dynamic/stories/U/US_SUPREME_COURT_HEALTH_OVERHAUL_SUBSIDIES?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2014-11-07-12-51-59</a></p>
<p>The Supreme Court is taking up the issue of the subsidies in states that use the federal exchanges. The law’s wording provides for subsidies only in those states that set up their own exchanges. The IRS ignored that wording and allows subsidies in states using the federal exchange. </p>
<p>Decision will likely come in June. </p>
<p>The IRS followed the clear intent of the law. </p>
<p>This whole brouhaha is about a typo.</p>
<p>No. It’s not a typo. There are supporters of ACA, Congressmen, saying that the intent of that provision was to get the states to set up exchanges. It was supposed to be a carrot. </p>
<p>The issue is whether constitutionally, the IRS (or any branch of the executive) can in essence re-write a law that is clear on its face. </p>
<p>This could set up a re-write of the whole thing. If the subsidies go in 30 some states, the individual mandate in those states would have to go. In order to re-shape the mess, some popular things will stay (the provision that 26 year olds can stay on their parents plan) and other parts will go. </p>
<p>I don’t think it will set up a whole rewrite of the law. States with their own marketplace will keep the subsidy. It’ll be like the states who expanded medicaid and those that didn’t. </p>
<p>I don’t care if states without their own marketplace can’t get subsidized. Since my state has their own marketplace, no one in NY will be effected.</p>
<p>If people in the states that get the subsidy taken away get angry enough they will have to try to convince their state governments to set up their own marketplaces. I am done caring about the people in those states. </p>
<p>According to Nina Totenberg, who knows her stuff, proponents of subsidies will argue that the law explicitly sets up the Federal exchange as a “state exchange”. I haven’t independently researched it, but if that’s true, the only way subsidies could be disallowed is if five of the Justices have an agenda.</p>
<p>Nina Totenberg never spent a day in law school. </p>
<p>I am tired of the subsidy argument. I agree with emilybee. You don’t want subsidies for your fellow citizens in your states. Fine. You don’t have to have them.</p>
<p>The country will survive.</p>
<p>The decision will be announced in June 2015. By that time, 5 million people will have been getting subsidies from the federal exchange for a year and a half. I don’t know if the government would be expected to claw back the subsidies, if the decision turns out to be against subsidies. Probably not, but who knows?</p>
<p>It’ll be interesting to see what the Supremes decide. They’d have to reverse King, the decison they’re taking up, and probably reverse Halbig as well. Halbig is currently scheduled to be reviewed en banc, and the en banc decision is widely expected to be in favor of subsidies for people on the federal exchange. I’m not sure whether the en banc review of Halbig is now mooted or not.</p>
<p>Plus, the people in all those states federal tax dollars will still be used to pay for those who can get subsidies in state’s with their own marketplaces. Win/win imo. Maybe even subsidies will be able to be increased for those who will get them. 
</p>
<p>The subsidy dollars are in the hands of the insurance companies. They might have to pay up.</p>
<p>No. The insurance companies won’t have to pay up. No way. </p>
<p>“The subsidy dollars are in the hands of the insurance companies. They might have to pay up.”</p>
<p>Eh? </p>
<p>The federal gov’t pays the insurance companies the subsidized amount from money they receive from US taxpayers from all 50 states. </p>
<p>Who might have to pay up? The insurance company pays claims from premiums paid to them which includes the subsidies they receive from the Fed. </p>