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Dutchess_III's avatar

What insurance companies come under the ACA?

Asked by Dutchess_III (36041points) April 2nd, 2014

I need to understand this a little better. Someone on fb posted that only 5 of the 30 cancer hospitals in the US will accept the ACA. But the ACA isn’t an insurer. It just set parameters on what existing insurance companies can and can’t do, right?
Also, they’re trying to up enrollment on all the insurance carriers to reduce premiums, right?
So it affects ALL insurance providers, include BCBS Silver plan? (On this post there was a claim that the Mayo Clinic only accepts BCBS Silver plans, which is not true, of course.)

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16 Answers

johnpowell's avatar

You are correct. The ACA just sets minumim requirements and sets up exchanges. It is up to the insurance companies to decide what is covered.

Take posts on FB with a healthy grain of salt.

augustlan's avatar

Yep, all of ‘em. I don’t see how a particular hospital could not ‘accept the ACA’, unless they didn’t accept insurance at all.

Judi's avatar

I noticed that the Oregon exchange didn’t have any of the big guys on the exchange. California had them all.

Darth_Algar's avatar

As a general rule only about 5% of the crap posted on Facebook is posted by people who have the slightest clue what the fuck they’re talking about.

johnpowell's avatar

Oregon has OHP so I am not sure if the big companies want to try to even compete here. A lot of people that aren’t covered from employers are covered by OHP (my mom included).

We have been dealing with this since the early 90’s.

“The Oregon Health Plan was conceived and realized in 1993 by emergency room doctor (and current Oregon governor) John Kitzhaber, then a state senator, and Dr. Ralph Crawshaw, a Portland activist. It was intended to make health care more available to the working poor, while rationing benefits. During the 1990s, Oregon was considered a national leader in health care reform.”

eno's avatar

Someone on fb posted that only 5 of the 30 cancer hospitals in the US will accept thee ACA

The FB content is correct, just poorly worded. This should clarify Obamacare: Many top cancer hospitals off-limits for newly insured

Dutchess_III's avatar

@eno Very interesting. So the people who are having a hard time are those who had NO insurance, or were uninsurable before.

eno's avatar

Yes, and those who had their original plans cancelled.

Dutchess_III's avatar

I just asked a question about that @eno. Why were some plans cancelled?

eno's avatar

Two reasons. Plans were non-compliant with ACA standards and there is no law that prevents insurers from cancelling plans for other reasons, like cancelling plans that are too expensive to maintain. So to save money, the insurer just dumps the customer on the exchange to purchase a shitier, cheaper plan.

Dutchess_III's avatar

So did those insurance companies just fold altogether, rather than become compliant? What do you think the biggest compliance issue was for the? The fact that you can’t refuse to insure someone with a pre-exisiting condition, or something else?

JLeslie's avatar

Those companies knew what they would have to comply with, anyone whining that all of a sudden they had to run around and find a new insurer should recognize that the Republicans love to point out ACA forced them to go out of business and left all these poor people without coverage, but fail to point out that people could have been given fair warning months and years ahead, but weren’t because the insurers didn’t want people to jump ship early. The insurance companies didn’t care about people beings insured and healthy, they care about the bottom line of the business. I guess maybe the companies were also hoping ACA would disappear or give some exception.

eno's avatar



Also, some insurers are waiting it out so that the insurance companies already participating in the exchange will enroll the huge influx of sick people and once that is complete, those insurers that waited at the sidelines will then join the exchange and profit from the those healthy individuals who didn’t sign up.

However, this individual mandate is a big concern for all the insurance companies. If the young and the healthy drop out because it is cheaper to pay a penalty, then insurance will only be attractive to the sick and old. If the sick and old are the majority of the pool, then the price of the insurance will rise for those who young and healthy who already have insurance. This, in turn, will cause even more young and healthy people to drop their plans. When that happens, most insurers would drop out of the exchange because they can no longer make a profit and since most insurers would drop, you would have less competition, so you would see even higher premiums.

Also, if someone young and/or healthy were to get sick, they don’t have to wait long to get coverage thanks to the ACA law. You just sign up when if and when you get sick and avoid paying for it until it actually happens.

Yes, pre-existing conditions would be the main compliance issue. Also, regulations on pricing, quality and transparency.

eno's avatar

It is posponed till 2016, but even the individual mandate penalty can be easily avoided—link

augustlan's avatar

So it’s not that the cancer centers don’t “accept the ACA”, it’s that the insurance companies opted not to include those centers in their networks.

eno's avatar

It is both. Technically, it isn’t incorrect to say that the cancer hospitals are rejecting the ACA because what the statement really means is that the cancer hospitals are rejecting the insurance companies that are participating in exchange. It is also true, however, that insurance companies are rejecting the hospitals in their plans.

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