Thirty-four percent fewer healthcare providers are available to Obamacare patients — backing up "anecdotal reports that exchange networks contain fewer providers than traditional commercial plans," a new report says.
According to an analysis
by Avalere Health, the Washington-based advisory firm, the Obamacare networks offer an average of 42 percent fewer heart and cancer doctors — along with 24 percent fewer hospitals and 32 percent fewer primary care physicians for patients to choose from.
But most importantly, the Affordable Care Act's restrictions on out-of-pocket costs by patients do not apply to healthcare services outside the plan's network.
"Out-of-network care does not accrue toward out-of-pocket maximums, leaving consumers vulnerable to high costs if they seek care from a provider not included in their plan’s network," said Elizabeth Carpenter, Avalere's vice president. "Patients should evaluate a plan’s provider network when picking insurance on the exchange."
Overall, however, the limited choices are seen as a way of keeping patient costs down, said Dan Mendelson, the firm's CEO.
"Plans continue to test new benefit designs in the exchange market," he said. "Given the new requirements put in place by the ACA, network design is one way plans can drive value-based care and keep premiums low."
Republicans and other health professionals have long charged that Obamacare has reduced healthcare coverage and choices for Americans.
"The American people are not happy on this birthday," Sally Pipes, president and CEO of the Pacific Research Institute, told Newsmax TV
as the law marked its fifth anniversary in March.
The report was based on a study of large healthcare networks in Florida, California, Texas, Georgia, and North Carolina, Avalere said.
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