I have been anti-ACA before it ever became law but I also am very suspicious of the private healthcare insurance sector of doing all they can to sabotage any form of healthcare reform. I think their massive cancellations were motivated as a tool to make their point. I also believe that they really are on the offense and will do things that hurt the public to make their point.
There are no good guys in this game between Obama and the healthcare industry.
When UHC and Aetna decided to reduce the number of doctors in their network, it was not an attempt to sabotage the healthcare reform. Health insurance companies are expecting a 10 to 14% yearly growth rate over the next 5 years due in large part from the healthcare law. To understand what is really going on, you have to know a little bit about Medicare Advantage.
These plans are alternatives to traditional Medicare. When a senior joins one of these plans, they sign over their Medicare benefits to the insurance company who pays their healthcare costs plus offering some additional benefits that Medicare doesn't offer.
As a result of legislation during the Bush years, Medicare Advantage plans were subsidized by the government to the tune of 12% above what the government pays for regular Medicare beneficiaries plus the government pays some of the insurance companies operating expenses. The idea was that once these plans were established they would reduce Medicare costs and CMS would phase out the subsidy. What actually happened is costs did not go down but increased substantially, 1/4 of the Medicare beneficiaries signed up for these plans and the insurance companies repeated huge profits.
Years ago, CMS, who managed Medicare programs began trying to cut back on these subsidies, but yielded to political pressure. Language was incorporated in the ACA which required that the subsidy be phased out over the next 10 years and this is what we're seeing today.
The insurance companies are attempting to maintain their profit margins by reducing some benefits, raising premiums, and reducing costs. UHC and Aetna are reducing cost by eliminating some of the higher cost providers from their networks.
There is nothing in the ACA that forces insurance companies to reduce the number of doctors in their networks. Most companies are eliminating some of the benefits that regular Medicare does not pay and still others are raising premiums. These are business decisions made by the insurance companies.
