“You would think it would be simple to find a health-exchange plan that allows me, living in San Diego, to continue to see my primary oncologist at Stanford University and my primary care doctors at the University of California, San Diego. Not so. UCSD has agreed to accept only one Covered California plan—a very restrictive Anthem EPO Plan”
So even an academic, government financed, non-profit entity, will not accept plans that do not allow their institution to make, you guessed it, a profit. Those institutions will be reserved for the elite pols, the wealthy, and for, at least now, Medicaid, and illegal aliens that qualify for Medicaid.
This poor man will have to find some way to qualify for Medicaid or Medicare. Perhaps he can renounce his citizenship and perfect a Spanish accent.
Commit a felony and get locked up and all your healthcare needs are met ....
The actual situation seems more perverse that that. The policies that I have reviewed all drop out of network coverage, which is how people used to see specialists when they were seriously ill. And they make the networks very limited. Similarly, the hospitals have negotiated exclusive contracts.
As an example of this, Anthem offers policies with the same terms and conditions in many counties in California. But unlike their previous policies, they have no out of network coverage at all, and Anthem restricts the networks by county. So for a particular policy offering, the Anthem network changes with the county you live in.
If you live in Los Angeles county, you can see the specialists at Cedars Sinai hospital. But if you live in San Bernadino you can't. Clearly Anthem has a contract with Cedars Sinai, and yet they don't provide any insurance coverage at all to a resident of nearby San Berdnadino or Riverside CA at that hospital.
I suspect the real reason for the strategy is to try to increase the profits of the insurers and maybe the hospitals by forcing patients to go to a small number of hospitals, thereby increasing the volume at those hospitals. In return for the promise of more business, the insurers asked for a wider spread on their discount price vs. the list price.