OK, name one case where that has actually happened -- where the state has successfully coerced a doctor to accept new patients at a loss or a provider to overpay to make such a doctor/group choose to accept new patients.
There is a good article on this problem (many doctors not accepting new patients, leaving regions without care except for ERs) on the front page of the 5/18/15 San Jose Mercury News.
> OK, name one case where that has actually happened -- where the state has successfully coerced a doctor to accept new patients at a loss or a provider to overpay to make such a doctor/group choose to accept new patients
It has nothing to do with coercing doctors. Why would it? If a insurance network can't meet its obligations it will be fined or shut down. If an insurer has to pay more money to a doctor in some area to meet its obligations it will then have to (though undoubtedly that will be eventually passed on to its customers).
Meanwhile it's an agonizingly slow process to get justice for the people that need it, but insurance companies forced to refund money for not meeting their network coverage requirements is in the news right now, specifically because "more than 25% of physicians listed by Anthem and Blue Shield weren't taking patients in the Covered California health exchange or were no longer at the location listed by the companies, according to the state's investigation."
That article talks about fines for overstating their networks -- stating in marketing materials that they had more participating doctor availability in given region(s) than they actually had availability for all policies offered. False advertising, in a sense.
That is very different from the problem statement: how do you make a network offer inducements at a loss to recruit additional providers?
I'd guess that most people buying off CoveredCA.org don't even bother to look at participating providers accepting new patients before buying a policy. There is no element of law that says to an underwriter, "Hey, you gotta add more providers in this area and that area now, or we will punish you." The law doesn't give government that power.
> That article talks about fines for overstating their networks -- stating in marketing materials that they had more participating doctor availability in given region(s) than they actually had availability for all policies offered. False advertising, in a sense.
They weren't falsely bragging about numbers in marketing materials, they were listing specific doctors at specific addresses in their tools for finding in-network doctors that were not in their network or were not at that address. Different from geographic density but related.
> That is very different from the problem statement: how do you make a network offer inducements at a loss to recruit additional providers?
It's really not complicated: by saying they can't operate in a certain area without a sufficient network. They either recruit more doctors or they pack up.
Perhaps you're missing that insurance companies in California don't usually operate statewide? I assume this is common across the country. The key is that care has to be available near your house or workplace. When applying for insurance you are specifically offered companies that have coverage in those areas (often at the county or city level of granularity).
You can't sign up for an insurance policy at the other end of the state from a company's network of doctors and expect them to sign up doctors around you, because, again, if they don't have sufficient density of doctors where you are, they don't cover people there in the first place.
> There is no element of law that says to an underwriter, "Hey, you gotta add more providers in this area and that area now, or we will punish you." The law doesn't give government that power.
If a insurance network can't meet its obligations
it will be fined or shut down
What are you claiming its obligations are? Its obligations are to pay valid claims made by covered parties. It does not have a legal obligation to add provider capacity to a given region.
There is a good article on this problem (many doctors not accepting new patients, leaving regions without care except for ERs) on the front page of the 5/18/15 San Jose Mercury News.