For 2014 and 2015, health plans available on the Insurance Exchange were good, very good in many cases.
Things in 2016, however, are really changing for the worse, for ACA customers. Some details about how bad it is getting follow. I continue to discover more negative changes daily.
BlueCross BlueShield is doing away with all of its PPO plans because they cost too much money.
None of the plans in Texas, created under orders from ACA rules, will cover M.D. Anderson, where I have been an active patient for 25 years. And that’s where it just begins.
There are 54 hospitals in the Houston Medical Center. United HealthCare will only cover 2 of these in 2016. (BCBSTX covers a tiny handful.) Patients will not be able to get live-saving health care at Herman, Texas Childrens, Methodist, Ben Taub, M.D. Anderson, and dozens of other places. United HealthCare does not even provide out-of-network (or non-prefered) coverage. Of the hundred plus hospitals within 20 miles of M.D. Anderson, United HealthCare only covers 8, period.
BlueCross BlueShield’s 2015 PPO plans cover 9,290 hospitals, doctors, pharmacies, etc. within 5 miles of M.D. Anderson with really low out-of-pocket maximums for in-network and out-of-network services. Basically, everything is (for a few more weeks) in-network.
BlueCross BlueShield’s 2016 HMO plans cover 3,294 (approximately -66% difference). There is no out-of-pocket annual maximum for non-preferred services, doctors, and medications. Basically, everything will be non-preferred.
In the state of Texas, BlueCross currently covers 114,743 hospitals, doctors, pharmacies, etc. In 2016, they are currently only going to cover 56,197 for ACA patients/customers. Most of the 56,197 are primary care physicians or pharmacies like CVS that are on almost every street corner.
BlueCross currently covers 647 hospitals. In 2016, they will only cover 329 in Texas.
There are thousands of patients, like me, who depend on high-quality, affordable healthcare. Hospitals and doctors, including M.D. Anderson, want to be on these plans but Aetna, Community Health Choice, United HealthCare, and BlueCross BlueShield say that saving life and allowing people to be healthy costs too much money and cuts into their profits too much.
Just a few days ago, BlueCross was ordered to cover East Texas Medical Center.
It’s not only customers in Texas, either.
And all of this is happening while the CEOs and executives of insurance companies make millions annually. Patricia Hemingway Hall, CEO of the company connected with BlueCross, made $12.9 million in 2011. CEOs at Aetna, Anthem, Cigna, Humana, United HealthCare took an average of $13.6 million home in 2014. And it only gets worse.
The United States desperately needs a single-payer system or something much, much better than we have now. CEOs of companies should not control life and death. Their income should not be based on how many they legally kill or hurt each year.
And this is not only an attack on people and their health because of a desire to make more money, it’s an attack on science, education, President Obama, poorer individuals, and the future. It’s terrorism, actually.
For additional countless examples, take a look at the replies, comments, and posts, customers are making on the BlueCross pages here, here, and here.
Please help get word out about what insurance companies are doing. Obamacare was designed to move the United States in a positive direction. For too long, people who actually used their health insurance or who had any kind of preexisting condition(s) found themselves with their service canceled and denied. Insurance companies are creating loopholes.
Mixing capitalism and health is a dangerous recipe. Insurance companies are only doing this to make more money, not to save money and certainly not to advance life and science and happiness for as many as possible.
Please see my followup post here: The Medical Industrial Complex: Media Inattention and What You Can Do About It
Dr. Andrew Joseph Pegoda 