quote:
think they should withhold the entire return. At least up to the cost of the subsidy. More people that see the effects on their bottom line will realize what a piece of shite this is. As a physician, I have seen a slight increase in revenue due to Obamacare, but I cannot say my income is up and may even be down. My insurance rates for me and my employees (which I pay 100%) are WAY up and due to go MUCH higher. My tax burden is up approx. $60-80k factoring in everything. My overhead is up due to more paperwork and other bullshite involved. Not to mention inflation which seems to be ignored.

So very true and nearly all PCP's are experiencing this.

What is staggering is the threat of back billing of the physician from the ACA. As it stands patients on ACA had first 90 days after signing up to pay their premiums. All visits in that time were essentially on good faith. If they failed to pay premium then any charges paid to the physician for services rendered were in error and thus recollectable. After the 90 days the patients needed to continue to pay regularly scheduled premiums. Other than cancelled check stubs, and a patients word, there is no reliable way to prove premiums are paid when they show up at an office visit. Fortunately, review of payment and enrollment retrospectively has shown that the vast majority are currently paying their premiums. However, a huge portion of those are subsidized greatly and thus have little to no out of pocket expense for premiums.

Since they are just now "discovering" people lie to get free stuff and many recipients of the ACA owe money on their plans both retrospectively and going forward it will put physicians and patients in a difficult position.

Docs are going to have to either:

Stop seeing ACA patients all together; or

Intentionally delay seeing patients that seemingly have insurance through ACA to prove that they are still enrolled weeks after premiums are due; or

Require proof of premium payment prior to each office visit. Which will require increased staff time and overhead; or

Or face repaying huge amounts of "erroneous payments" for services rendered at increased overhead due to the patients not actually having coverage. And resultantly pass the bills on the to the patients that have for many years not seen a physician due to either lack of funding or lack of desire to use funds to pay for health care needs.

And this does not even address the deductible or copayments that most of these patients don't understand, don't have funds to pay, and or choose to blame the physician for.