Editorials & Other Articles

antigop

(12,778 posts) Tue Jun 16, 2015, 10:54 AM Jun 2015

WSJ: Surprise Bills for Many Under Health Law

Out-of-network charges often aren’t flagged before treatment, consumers say; states tightening laws
http://www.wsj.com/articles/surprise-bills-for-many-under-health-law-1434042543

Many consumers with health coverage through the Affordable Care Act are facing unexpected medical bills that in some cases greatly exceed the law’s caps on out-of-pocket expenses.

The law’s limits don’t apply to charges from out-of-network providers, and many insurance plans sold on ACA exchanges have limited networks—amplifying the risk of surprise bills.

Health plans offered by employers also have been slimming down the number of doctors and hospitals in their networks. But what have come to be known as narrow networks are more prevalent in plans offered on the health law’s exchanges, one tactic insurers are using to curtail costs because they can’t exclude consumers with existing medical conditions.

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WSJ: Surprise Bills for Many Under Health Law (Original Post) antigop Jun 2015 OP

That has always been the case especially for HMOs, and is NOT due to the ACA. It is also very still_one Jun 2015 #1

oh, good grief. The ACA didn't fix the problem. antigop Jun 2015 #3

If they didn't want to worry about out-of-network providers than they would choose a PPO. However, still_one Jun 2015 #5

oh, good grief: "The law’s limits don’t apply to charges from out-of-network providers..." antigop Jun 2015 #6

The insurance companies are the problem... Human101948 Jun 2015 #2

"The law’s limits don’t apply to charges from out-of-network providers.." antigop Jun 2015 #4

The issue is the same with Medicare. In fact not all physicians will even accept medicare, and the still_one Jun 2015 #7

umm...The insurance companies are now part of every American's life, by law, thanks to Doctor_J Jun 2015 #8

still_one

(92,409 posts)

1. That has always been the case especially for HMOs, and is NOT due to the ACA. It is also very

Reply to antigop (Original post)

Tue Jun 16, 2015, 11:03 AM

Jun 2015

clearly stated in the respective policies between In Network verses out of Network.

antigop

(12,778 posts)

3. oh, good grief. The ACA didn't fix the problem.

Reply to still_one (Reply #1)

Tue Jun 16, 2015, 11:38 AM

Jun 2015

"The law’s limits don’t apply to charges from out-of-network providers..."

still_one

(92,409 posts)

5. If they didn't want to worry about out-of-network providers than they would choose a PPO. However,

Reply to antigop (Reply #3)

Tue Jun 16, 2015, 12:52 PM

Jun 2015

PPO premiums cost more.

The purpose of the ACA wasn't to address this problem, it was mostly insurance reform, and to insure the uninsured.

In addition, the issue you mentioned would NOT be corrected by socialized medicine or Medicare for all, which incidentally I am all for, but doubt it will happen.

Not everyone accepts Medicare or those covered under the ACA. Texas is notorious for physicians who do not accept Medicare for example. In addition, unless you have an advantage plan, you need some kind of supplemental plan under Medicare or you could incur some major costs.

antigop

(12,778 posts)

6. oh, good grief: "The law’s limits don’t apply to charges from out-of-network providers..."

Reply to still_one (Reply #5)

Tue Jun 16, 2015, 12:55 PM

Jun 2015

Human101948

(3,457 posts)

2. The insurance companies are the problem...

Reply to antigop (Original post)

Tue Jun 16, 2015, 11:12 AM

Jun 2015

Republicans keep framing every problem in healthcare as being the fault of Obamacare when 95% of the time it's the fault of the insurance companies.

antigop

(12,778 posts)

4. "The law’s limits don’t apply to charges from out-of-network providers.."

Reply to Human101948 (Reply #2)

Tue Jun 16, 2015, 11:40 AM

Jun 2015

The ACA didn't fix the problem, so, yeah, the ACA is part of the problem.

still_one

(92,409 posts)

7. The issue is the same with Medicare. In fact not all physicians will even accept medicare, and the

Reply to Human101948 (Reply #2)

Tue Jun 16, 2015, 12:57 PM

Jun 2015

same would apply to a socialized medical system, not everyone facility would be compelled to accept it, and I do not see anywhere that the law can or will be changed to make it so. Canada and Great Britain have private facilities for those who do not want to go through the system.

Doctor_J

(36,392 posts)

8. umm...The insurance companies are now part of every American's life, by law, thanks to