In the News

Obamacare Does Not Equal Access to the Care Patients May Want


Republicans have long warned that Obamacare did nothing to ensure that Americans would have timely access to quality and affordable health care from the providers they choose. Now, nearly six months after the law has taken effect, these warnings are becoming a reality. The law’s many mandates and controls have led to a predictable outcome: narrower networks and limited choices. Sadly, this means that the president’s promise of, “If you like your doctor, you will be able to keep your doctor,” will not hold true for many Americans, a reality that even one of the law’s chief architects reluctantly admitted would always be the case. Forcing individuals to purchase health insurance does not ensure they have access to health care from the doctors they choose.  

May 12, 2014

More Insured, but the Choices Are Narrowing

In the midst of all the turmoil in health care these days, one thing is becoming clear: No matter what kind of health plan consumers choose, they will find fewer doctors and hospitals in their network — or pay much more for the privilege of going to any provider they want.

These so-called narrow networks, featuring limited groups of providers, have made a big entrance on the newly created state insurance exchanges, where they are a common feature in many of the plans. While the sizes of the networks vary considerably, many plans now exclude at least some large hospitals or doctors’ groups. Smaller networks are also becoming more common in health care coverage offered by employers and in private Medicare Advantage plans.

Insurers, ranging from national behemoths like WellPoint, UnitedHealth and Aetna to much smaller local carriers, are fully embracing the idea, saying narrower networks are essential to controlling costs and managing care. Major players contend they can avoid the uproar that crippled a similar push in the 1990s. …

But while there is evidence that consumers are willing to sacrifice some choice in favor of lower prices, many critics, including political opponents of the new health care law, remain wary about narrowing networks. A concern is that insurers will limit access to specialists or certain hospitals. “Too often, Obamacare cancels the policy you wanted to keep and tells you what policy to buy,” Senator Lamar Alexander, a Tennessee Republican, said in a speech in April. …

Outside the exchanges, insurers are also promoting smaller networks for employers as a way to reduce overall health care costs, said Larry Boress, chief executive of the Midwest Business Group on Health. “The larger the network is, the higher the cost,” he said.

Employers remain concerned about the quality of the networks, said Mr. Boress, and many are doing an analysis to see how disruptive changing the network would be for their workers.

Nonetheless, the bottom line is that more employers are considering smaller networks. Many, like Walmart and General Electric, have gone so far as to steer employees to specific hospitals for certain expensive procedures like joint replacements. …

Read the article online HERE.


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