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Doctors can pick and choose what medical plans they will accept from a given provider. There is nothing obligating them to accept insurance that they feel is not financially advantageous or is overly burdensome. A given doctor may accept a few Aetna PPOs, but not other Aetna plans. In t his case the doctors will simply be opting not to accept health insurance plans from private insurers that are being sold on the exchanges because they know they will be carrying the rest of the ACA regulations and added expense with them.
In the average doctors office it isn't uncommon to see them hire coders and insurance managers that specialize in various insurance plan billing. A doctor that accepts Medicare is almost required to pay an employee just to navigate Medicare billing.
Accepting an ACA derived plan would likely require they hire yet another person to navigate the this new mess foisted on them by the government.... or simply not hire someone and not accept the insurance.
What extra expense? The patients have insurance. What difference does it make to the doctor whether or not that policy was sold on an exchange?
It's not like they're dealing with a new insurance company with new regulations.