Obamacare is shrinking access to doctors

A new report out from the Robert Wood Johnson Foundation finds that some U.S. patients are paying more under Obamacare because the president’s healthcare overhaul is shrinking the size of provider networks available under many plans.

According to the report, 4 in 10 plans offered on the Obamacare exchange qualify as so-called “narrow networks.” That means that they cover fewer than 25 percent of available physicians in an area. Eleven percent of those plans are considered “extra small,” meaning they only cover visits to 10 percent of the doctors in an area.

Narrow networks are gaining in popularity under Obamacare as a way to help insurance companies cut costs.

The report explains:

Insurers can use narrow networks to lower premiums in various ways. They can directly exclude high-cost providers from the network and direct patients to high-value providers. They can use the market power of networks to negotiate lower reimbursement levels with participating providers in exchange for greater volume, thereby keeping prices low. They can segment their network into tiers, with higher cost-sharing for the higher tiers, resulting in a de facto narrowing of the network for priceconscious consumers.

But while it may be good for insurance companies, the trend is likely to hurt patients in the long run.

The researchers note:

Narrow networks leave consumers vulnerable to the financial burden of out-of-network care; the challenge of navigating between in-network providers increases as the network size decreases. As a result, network size, even as a broad concept, is an important feature of a plan.

The report further warns that many Obamacare enrollees make pick plans with lower premiums without understanding that they come with narrow networks that could drive up costs exponentially.

“Consumers need to be able to see the forest as well as the trees when they make a plan choice and these data are a first step in giving them the full picture of which physicians are covered under specific plans,” said Kathy Hempstead of the Robert Wood Johnson Foundation.

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