ACA Database: Are There Any Plans in the Works to Force Doctors to Accept Obamacare?

flying cadeuciiAfter several attempts at trying to find doctors who accept my lame-o ACA health plan (Blue Cross Blue Shield advantage HMO), I finally reached my limit today when a rather important appointment got cancelled unless I wanted to pay cash, because “we don’t accept your policy”.  When I googled “none of my doctors accept my Obamacare health insurance”, your article came up.

Do you or does anyone else know if there is some kind of plan of action for doctors to be forced to accept these ACA plans?  This year alone, I have yet to visit ONE of my previous doctors who will accept an ACA plan (and I didn’t even get the cheapest plan!).  Having had past surgeries, I feel it imperative to “go with who you know”, in that I want to see my past surgeon when there is a problem a year later that might need to be addressed.  Beyond frustrated!  And I don’t even live in a small town!!  I am in Dallas, Texas, with thousands of doctors!

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26 replies »

  1. This is why we all need to take better and more consideration when we vote. The ACA is a step in taking back the power from the large wealthy pharmaceutical and insurance corporations. We shouldn’t give up, but push the Federal government to enforce ACA better, force insurance and drug companies to lower costs and leave the medical decisions in the hands of the Doctors and the patients.

  2. Go Allen!
    Maggie, if an individual is not smart enough to choose a doctor they can afford then it does not mean the doctor should charge them less. Posted rates are posted rates. Allen is right. Overcharging would only be if they charged you more than they said would.

  3. Maggie, my doctor deserves to be in the 1% if that is in fact where he is at. He puts in 14-15 hour days, is an amazing at diagnosis, will keep me in the office until he is satisfied he has answered all my questions and addressed my issues, he has 30+ years of experience, research and continuing education. I myself am not in the 1% but I don’t damn anyone for working hard and educating themselves to provide excellent care for being in the 1%.
    I do damn the insurance companies, with their uneducated paper pushers, raking in profits for their CEO’s at the expense of my doctor and his valuable time and expertise.
    The insurance companies will be the downfall of medicine (and more) in this country. That is were we need to focus our energies-shaking down the insurance industry greed mongers.

  4. Great description of what is happening.
    Here is another analogy:
    Lets say you have someone come and clean your house. They spend 4 hours for $25 per hour. When they leave and say they would like to be paid for their service: your home is clean and tidy, they did a good job. But, you tell them”Fill out this paperwork and explain in great detail just exactly what you did and then come back in 4 weeks and I’ll pay you”. So off they go, submit the paperwork and then come back to be paid and you say “uh, I’m gonna pay you $25 dollars for your work because that is what I deem is the right amount” “just because”.
    It would never work in the non-insurance world. You can’t pay someone a 1/4 of what their bill is “just because” like insurance companies do.

    Or how about this, you pay them the full amount and then in 12-14 months from the date of service you send them a bill and say they need to pay you back 75% of what you paid them or you will send them to collections.

    My doctor deserves better treatment and respect. This healthcare system is un-sustainable and the good, independent doctors will be forced out at the same time the system will be taxed with all the aging baby boomers!

  5. You are either a doctor yourself, or a brilliant person that “gets it.” Either way, I’d vote for you for President. Everything you said is 100% correct.

  6. Obamacare should be repealed. Healthcare is suffering. Insurance costs are skyrocketing, with less coverage. Plus, if you are in the group of people who couldn’t afford it before and didn’t qualify for help your probably still there. Oh, fining people who don’t have insurance is an idiot move. If you can’t afford insurance you can’t afford that fine. We need some common sense in the white house.
    Natural Healthy Life Ideas

  7. Maggie writes: “some providers overcharge by 200% to 300%.”

    What do you mean ‘overcharge’? If that is someone’s fee they are not overcharging. If they charge higher than their stated fee, that is overcharging. Please help me with your definition of overcharge.

    I am not debating the fact that some physicians charge incredibly high rates. I am not debating the impact of those high rates. I am solely questioning your use of the word ‘overcharging’ as if there is some tablet written by the heavens that dictates the individual charges that should be made by each individual physician.

    “Also Medicare is going to begin to crack down on providers who charge obscene fees.”

    Since Medicare dictates fees to those signed up with Medicare how are they going to crack down on providers that charge what you call “obscene fees”?

  8. Maggie writes: “ the majority of doctors enjoy incomes that put them in the top 1%–“

    I wonder what that means? Does Maggie not believe in merit based pay? Should government decide how much everyone gets paid?

    By the way, before the ACA was passed plenty of doctors didn’t accept many types of insurance policies so the claim that it is due to “a very conservative political ideology” appears false. Generally most businessmen, and doctors included in that description will put away ideology and accept a fee that coincides with what they feel they are worth.

  9. Bicycle–

    You are night–when the ACA was passed, no one could address the fact that
    some providers overcharge by 200% to 300%.

    If legislators had addressed that issue the ACA would never have passed. (As we all know, lobbyists control Congress–and both doctors and hospitals have very, very powerful lobbyists.)

    But now that the ACA has passed, state insurance regulators are being much tougher. Particularly in states like California, they are refusing to let insurers join the
    exchanges if their premiums are too high. This means that if some doctors and hospitals are over-charging, insurers can no longer just raise their premiums to
    cover the costs. Instead they are refusing to admit these providers to their networks.
    (In NYC Memorial Sloan Kettering is not being included in networks. Some patients
    are not happy about this, but the fact is that if you look at patient reviews of
    Sloan Kettering, you will find that it is not focused on patient-centered care)

    In time, as more and more patients join the Exchanges, providers who over-charge are going to have a hard time staying in business.

    Also Medicare is going to begin to crack down on providers who charge obscene fees. Things are changing–though it will take time.

  10. Maggie, the docs in NYC do take Obamacare due to money driven medicine of seeing large volumes of patients to make more money. I met docs in NYC and quite a few of them work 7 days a week, with the rule that they won’t go home as long as patients keep coming. One clinic I know works 24 hours in shifts to save on rent money. I don’t know but that’s pretty greedy/hungry to me (as are many folks I have seen in NYC and that’s why I left there.) Some bad docs are actually paying patients with Medicaid and Medicare kickbacks like vitamins to get them in. That’s the liberal NYC medicine for ya. That’s why Medicaid costs and fraud is out of this world in NYC. Kinda sad for the good doctors practicing there.

  11. Maggie, given the talent and the opportunity cost of about a McDonald’s franchise, and working 60 hours a week or more, I think the docs can go into any profession and be at the top 1%. Theoretically, they should be making as much as McDonalds franchise owner without question. Do people question why Micky Dee owners make and call them greedy and money driven? When dropouts like Snowden are making 250K, and illegals with no skills are demanding $15 an hour, you asking the top student of a university class who will commit to spending 500K, and another 8 years minimum after college to make less than dropout Snowden? Lawyers have much easier time getting there and charge as much per hour. But the liberals don’t dare to touch them because of their political power. I am sure lawyers help the society as much as doctors.

    People get paid for a reason and shouldering 10 million dollar liabilities all the time which can mean losing everything you have and a broken family is something that regular folks are not going to take at a regular or any salary. Would you?

    I do hope the doctor who will be repairing you one day makes more money than the Mercedes mechanic who regularly makes six figures not counting overtime. I expect that for mine.

  12. I hope you realize that the majority of doctors enjoy incomes that put them in the top 1%–
    after overhead, student loans, etc.

  13. Your doctors are refusing to take Obamacare because they are in Texas.
    This is not fair to you–or anyone else in Texas–but this is all about a very conservative
    political ideology which is telling people (including doctors ) that they should do everything
    they can do to oppose Obamacare.

    In New York City (where I live) all of the doctors I see ( high-end doctors who charge private insurers very high fees), accept Obamacare’s the lower fees that state regulators have

    In time, this will change. Patients in Texas will put more and more pressure on their
    legislators to join health care reform,and doctors will find that those who refuse O-care
    will be losing patients.

  14. “The notion of healthcare is a right and should be free is retarded.”

    The conflation of a “right” with “coming at no cost” is doubly so.

  15. I don’t know whether this article is a joke or for real but let me explain the math behind the whole thing and hope it makes sense. The healthcare situation is much like the housing bubble. People go around expecting to buy McMansion with no money down, no income/asset and expect to live like a king and cash out with half a mil in profit in a few years. Americans want everything and want to not pay for it too. It ‘s gotta come from somewhere.

    It’s the same sense of entitlement with healthcare. People say “I want the doc to spend the time and attention. I want all the latest tests. I want all the expensive and best drugs with the least side effects. And if things F up, I am gonna have lawyers to sue for 10 million cause that’s what my life is worth.” The people say What? Why’s the bill a grand? Why isn’t this for free? Healthcare should be free, just like housing and food…by the way it better be the McMansion and steak/lobsters. There is no free lunch folks. You pay for what you get like in housing and food.

    The American system of liability forces docs to over-treat to make sure they don’t get sued. The insurance system takes away any incentives to save money cause it’s free like an expense account except there is no boss to watch over ya. The drug companies say “Hey, if your life is worth 10 mil, a cool grand per pill (see Sovaldi) is chump change.” Rightly so, an oil change for a cheap 100K Mercedes is a grand. I bet if a doc charges you a grand for a tune up on your 10 million dollar life, you are going to whine. So on one end (the trial court) the American people are saying their lives are worth 10 million. Then the other end, they are saying it ain’t even worth 100K when it comes time to pay for it. That’s the problem with American healthcare. Americans expect everything, and wanna sue for that much, but don’t want to pay even a fraction of the price.

    So why don’t docs wanna accept more business? Are they stupid or lazy? Absolutely not. No one says no to new businesses. But if someone comes to the Mercedes dealer with his 500SEL or whatever, and say I will give you 150 bucks for an oil change and oh, you gotta get it from my uncle Bob who is gonna make you file paperwork and not pay you half of the time (for decent insurances), the dealer would say go get a life. Docs are getting paid like 80-100 bucks per visit, certainly a whole lot less than an oil change on a cheap BMW.

    So forcing docs to take under-paid insurances because you were too cheap to pay for a good plan (and if you are young, you also likely voted for Obama to take on the financial burden of the healthcare system as a young person), is like having me demand that you get paid 1/4 or less of what you make because it’s so important to your customers and it “should be free” according to the liberals. A real scenario that is happening can be seen in Venezuela were the government is confiscating companies because they can’t provide products at pennies on the dollar OF THEIR COST. Similar thing happened to Canada when it socialized medicine and docs left. Even in Taiwan, where the single payer model is sold as the perfect system to folks outside the country. There is a severe shortage on docs that are in high risk specialties like surgery, ER, ObGYN as they get paid 5 dollars a visit and risk getting sued for a million. Would you take a job like that? Yes, nurses and even the faith healers may be cheaper, you get what you pay for. As long as trial lawyers control the politics in the U.S., healthcare costs will continue to escalate to 100K a year. Insurances may try to monopolize, or you folks may propose a monopoly to force docs under the single payer system. However, socialism just steals from the productive people until there is no more to steal. Folks will go elsewhere. I see the liberals want to force them to “stay” like caging them. At what point do we stop being a free nation.

    The notion of healthcare is a right and should be free is retarded. You ask that of housing or food? Not only that, the lawyers are making sure that it’s the McMansion or Filet Mignon/Lobster or get sued. It doesn’t work but the lawyers won’t give up. The people won’t want to pay. The docs with very little political power due to the lame AMA will give in until there is no more to give….like in this instance. Having to turn away business because it simply can’t sustain. It must be sick and sad to see business go away. Docs are not stupid.

    I hope you get a sense of how hopeless healthcare in America is. That’s why docs want to accept cash so they at least get paid something most of the time. I am not gonna get into the malpractice costs and new laws forcing electronic healthcare on doctors offices at the tune of 40-250K, never mind having to hire a scribe (the fastest growing healthcare job) at 40K a year. I don’t know but you wanting to go in with a insurance that pays pennies on the dollar with high deductibles which you are likely not gonna pay anyway (free customer), and insurances weasel away half of the time for “no referral” or what. Then shouldering the 10 million dollar liability if you ain’t happy? Doctors may be compassionate but they are not stupid. I hope you are not stupid enough to think the government should step in to force you to take a deal like that for your job.

  16. The ACA is simply a huge insurance regulation reform law with a few QI and P4P reimbursement reform pilots thrown in. The private for-profit insurance industry has to be regulated one way or another. ALL commerce gets regulated one way or another.

    Doctors and hospitals remain free to accept or reject insurance plans from among the thousands of ACA-compliant offerings as they see fit. There’s no insurance plan or company called “ObamaCare.” Again, this post headline was pure clickbait.

  17. ACA (Obamacare) is not an insurance policy. It is a misrepresentation to say that doctors maybe forced to accept Obamacare. There may be some policies that are sold through the exchanges that were established by ACA that some physicians may choose not to accept. But there are also policies that are not sold through ACA that physicians may not choose to accept.

    As long as we, as a nation, treat health care as a commodity to be bought and sold at a profit…especially health care financing (health care insurance) we will pay far too much for far too little. Take the profit out of health care and put the patient first as it should be.

    Support single-payer heath care. Support HR 676. HR 676 would provide health care financing for everyone (100%) for comprehensive medical, dental and vision care. With HR 676 there would be NO copays, NO deductibles, NO bankruptcies due to medical bills every again. HR 676 would provide this financial security for a tax that would be less than 98% of us currently pay for our health care insurance premiums.

    Check out HR 676 for yourself at http://www.healthcare-now.org and http://www.pnhp.org and http://www.mforall.org and on my Facebook page.

  18. Dear Bicycle_Girl,

    I think I love you . . .

    however, even though you are happily married, child-free-by-choice, and in pristine health, based your pic you do not look very well. It’s probably good that you have health coverage, even if your deductibles are sky-high (like mine).

  19. Yep, all you mean ol’ doctors who thought you were practicing medicine in a capitalist system, welcome to the United States of Obama!!!

    You had better get ready for that IRS Audit!!!

  20. Christine, your response seems a bit disingenuous at best when you know darn well that policies sold off the welfare exchange are grossly more expensive since there is no subsidy to offset the true cost of the policy. And yes, all these policies have the same useless coverages that you can’t opt out of. It’s comforting to know that as a happily married, child-free-by-choice woman in pristine health, that I am now covered for maternity/newborn care and pediatric dental. As a drug-free, mentally sound individual, it’s also comforting to know my rehab and psych services are also covered…..All this security, provided of course, you can meet your thousands-of-dollars deductible.

    The ACA is pure garbage for those of us who don’t have pre-existing conditions. If you’d like to help this gentleman, stop peddling the liberal, candy-coated drivel. There is absolutely nothing you or anyone else can do to help this man. We are ALL screwed by this law until real politicians with real integrity and honesty step up to the plate and repeal this cluster….

  21. The fact that so many doctors are refusing such policies is because they reimburse below what providers charge. Of course, the obscene amounts providers charge is the primary problem and the ACA did absolutely zero to change this. No one in the medical lobby wanted to hear the term “price caps”.

  22. What many consumers don’t realize is that 90% of the time insurers have the exact ACA plan offered privately. Same price, same coverage, just more doctors. When you shop for insurance, it’s super important that you buy the plan that covers your specific dr’s & meds upfront, not the other way around.

    Doctors can’t be forced to accept ACA plans, and it’s unlikely that will happen, however, it is likely that a ruling could force insurers to offer offer more dr’s in their network, and/or force them to increase dr fees so they are closer to what they would receive from nonACA plans.
    If you have any other questions or want help finding a plan that’s a perfect fit, I’d be happy to help. Christine at Impacthealth dot io