Consumers Losing Doctors On Some ACA Insurance Plans

By  //  May 15, 2014

LOWER PREMIUMS AT THE EXPENSE OF LIMITED PROVIDER NETWORKS

EDITOR’S NOTE:  In November of last year we reported that many consumers who were shopping for health insurance on the Affordable Care Act (ACA, aka Obamacare) health insurance exchange (HIX) marketplaces were discovering, much to their chagrin and in direct disaccord with President Obama’s assurance that “if you like your physician, you can keep your physician,” that many of the available plans on the HIX restrict the choice of doctors and hospitals in order to keep premiums low and “affordable.”

Today, in the report excerpted below, the Associated Press confirms that consumers across the country are discovering that, under Obamacare, “they bought plans with limited doctor and hospital networks, some after websites that mistakenly said their doctors were included.”

With insurers limiting health plan provider networks to hold down costs under Obamacare, some HIX shoppers will find their physicians or hospital of choice may not be available to them.
With insurers limiting health plan provider networks to hold down costs under Obamacare, some HIX enrollees have found their physicians or hospital of choice are not available to them.

With HIX insurers banking on the willingness of consumers in the market to forgo some flexibility and choice in exchange for lower premiums, even before the law took effect, experts warned that the cheaper plans’ narrow networks could impact patient’s access to care. 

Plans that offer limited provider networks typically offer lower premiums because they have either excluded the most expensive providers or insurers have negotiated discounts with participating providers in exchange for routing them more volumes. However, “with insurance cards now in hand, consumers are finding their access limited across all price ranges.”

This situation has been exacerbated by some healthcare providers who have resisted being in exchange networks because they are unhappy with the reimbursement rates or are concerned that the exchanges could be dominated by sick people who won’t be able to pay their portion of the bills.

– Dr. Jim Palermo, Editor-in-Chief

AP — Some consumers who bought insurance under President Barack Obama’s health care law are experiencing buyer’s remorse after realizing that their longtime doctors aren’t accepting the new plans.

obamacare3-300x174Before the law took effect, experts warned that narrow networks could impact patients’ access to care, especially in cheaper plans.

But with insurance cards now in hand, consumers are finding their access limited across all price ranges – sometimes even after they were told their plan would include their current doctor.

CLICK HERE to read the complete story on AP.org.

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