« Oct. 1 marketplace launch has some bugs to work out | Main | HCA East Florida and Nova Southeastern University propose a new teaching hospital to serve South Florida »

Consumers will pay more to have greater choice of providers in new healthcare marketplace

Federal officials often say that health insurance will cost consumers less than expected under President Obama’s health care law. But they rarely mention one big reason: many insurers are significantly limiting the choices of doctors and hospitals available to consumers, reports the New York Times.

Changes dictated by the Affordable Care Act, such as guaranteed coverage for people with preexisting conditions and not charging women more than men, haven't made insurance companies any gentler, kindler or less profit-minded. Given the new actuarial factors allowed under the Affordable Care Act, they're finding ways to make the cost of health insurance attractive enough for consumers to buy it, while holding or improving their bottom lines.

In many states including Florida, one way insurers are driving down premium prices is by restricting the number of providers who will treat patients in their new health plans, says NYT. 

"When insurance marketplaces open on Oct. 1, most of those shopping for coverage will be low- and moderate-income people for whom price is paramount. To hold down costs, insurers say, they have created smaller networks of doctors and hospitals than are typically found in commercial insurance. And those health care providers will, in many cases, be paid less than what they have been receiving from commercial insurers.

"Some consumer advocates and health care providers are increasingly concerned. Decades of experience with Medicaid, the program for low-income people, show that having an insurance card does not guarantee access to specialists or other providers.

"Consumers should be prepared for 'much tighter, narrower networks' of doctors and hospitals, said Adam M. Linker, a health policy analyst at the North Carolina Justice Center, a statewide advocacy group. Read more


Feed You can follow this conversation by subscribing to the comment feed for this post.

The comments to this entry are closed.