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ACA Fail Fractal
Consumers Revolt Against ACA's Narrow Networks

Consumer unrest over the Affordable Care Act’s narrow networks is boiling over in California. Fears about hikes in premium costs have dominated the coverage of the ACA, but a new lawsuit points to a different problem with the law. The LA Times reports that 33 customers of Anthem Blue Cross, a large insurer, are suing the company for limiting their choice of providers. More:

 Anthem members accuse the company of misrepresenting the size of its physician networks and the insurance benefits provided in new plans offered under the Affordable Care Act.

In many cases, consumers say, Anthem canceled their more generous PPO, or preferred-provider organization, plan and moved them to a more limited EPO, or exclusive-provider-organization, policy.[…]

As a result, some consumers incurred unforeseen medical bills when they were treated by out-of-network doctors, according to the suit. EPO health plans usually have little or no coverage outside the network.

The Affordable Care Act has lately become more unpopular than ever, even though coverage has expanded (at least in name), and some states saw only average premium hikes. This lawsuit might point to a major reason why: Consumers don’t like to have their choices limited, especially as the result of having their plans cancelled.

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  • Andrew Allison

    The insurance companies narrowed their networks to reduce costs. It may be that Anthem didn’t adequately disclose the meaning of EPO, but at the end of the day, if the networks expand, premiums will go up even faster than they are doing, perhaps enough to initiate the “death spiral” of declining participation.

  • Chris_8304

    I don’t think these plaintiffs have much of a chance of success. At this point these consumers only recourse is in the voting booth. Congress has the right to regulate health insurance in a way that narrows networks, even if they told their constituents, “if you like your doctor, you can keep your doctor”.

    • rheddles

      Where does the Constitution give Congress the right to regulate health insurance?

      • Chris_8304

        Not saying I agree, but see “NFIB v. Sebelius – the Constitution as interpreted by SCOTUS.

        • rheddles

          NFIB said the individual mandate was a tax and allowable as such. A majority of the justices said the mandate was not allowed under the commerce clause. The pretzel Roberts tied himself into.

  • Suzyqpie

    ObamaCare has created a debris field for consumers and a profit bonanza for WS. The plan is working.

  • FriendlyGoat

    I hope the plaintiffs prevail. The narrowing networks are a corporate idea gone too far. Conservatives want to blame the ACA, of course, but we need to simply blame the insurers.

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