Insurers to Offer Fewer Providers Under Obamacare Plans

Monday, 23 Sep 2013 10:09 AM

By Melanie Batley

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Insurers participating in the Obamacare insurance exchanges plan to offer a significantly narrower choice of providers to keep premium costs down, leaving many consumers with fewer options than available under existing commercial plans.

According to The New York Times, many patients will be unable to continue to use their own doctors or hospitals, and some could face higher costs for going outside of their networks.

The healthcare providers who participate in exchange plans, meanwhile, will in many cases be paid less than what they have been receiving from commercial insurers.

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Consumers should be prepared for "much tighter, narrower networks" of doctors and hospitals, Adam Linker, a health policy analyst at the North Carolina Justice Center, told the Times.

"That can be positive for consumers if it holds down premiums and drives people to higher-quality providers. But there is also a risk because, under some health plans, consumers can end up with astronomical costs if they go to providers outside the network," he said.

Insurers say the only way they can guarantee lower-cost plans for the exchanges is to be selective about providers. Anthem Blue Cross and Blue Shield of New Hampshire, for example, is excluding 10 of the state's 26 hospitals from the health plans it will sell through the insurance exchange, the Times reports.

"Many consumers will have to drive 30 minutes to an hour to reach other doctors and hospitals," said Peter Gosline, chief executive of the New Hampshire-based Monadnock Community Hospital, one of the hospitals excluded from the Anthem exchange plan.

"It's very inconvenient for patients, and at times it's a hardship," he told the Times.
The insurance marketplaces will be open for enrollment on Oct. 1, with coverage taking effect Jan. 1.

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