There's more likely than not some bad faith activity going on. They are essentially watering down what it means to have insurance, since they are required to sell it to people that they wouldn't otherwise have and are trying to make up the difference. One way or another, we're all paying drastically higher expenses than we would have before. If I have to pay the denied claims in my case, I'm looking at a $9800 out of pocket expense, on top of the $5K/yr premium I pay as a healthy nonsmoker.

Anthem pulled out of my state altogether for 2018, so I also had to switch providers at the beginning of the year (this claim was from late 2017). I think that's another reason they are giving me issues with this claim - they simply don't care because they no longer have to deal with my state's insurance regulator. The new insurance provider (which was the only choice I had in my area, regardless of price) so far appears to be even worse and more expensive. Something has to be done about all of this. I don't pretend to have the answer, but the ACA was apparently not it.