HHS to Force Insurers to Have Wider Networks
Health plans selling on the federal marketplaces in 2015 must include 30 percent of area “essential community providers,” which are usually health centers and other hospitals serving mostly low-income patients. That’s up from a 20 percent requirement in 2014, the first year of expanded overage under the health care law. (Washington Post)
A step in the right direction, but how much more expensive are those wider network plans going to be?
“You may find out that network is more expensive than another network, then you have to make choices in terms of what’s right for your family,” Obama told WebMD. “Do you want to save on costs, or do you want to save on convenience?”
Well the costs on the marketplace are already burying people. They probably won’t have the option to make the right choices for their family.
I can almost imagine a $1300 monthly premium with a wider network through ObamaCare.
“What is different now is the Affordable Care Act marks the first time that federal law requires insurance plans to offer adequate networks of doctors, including mental health practitioners, pharmacies, hospitals, and community providers.”
They offer all of this at a price. However, the chances of that price being adequate for individuals is doubtful.
Are they actually forcing for wider networks? What I get from this post is that the new requirement is 30 percent of the area “essential community providers” instead of 20 percent that is currently forced by law. This means that providers are going to choose institutions of lower quality and that meet the requirements of an “essential community providers” rather than better institutions to abide by the law. Networks won’t be wider; they will have a lower quality.
How many health care facilities will be open to accepting more plans off of the exchanges? They all could likely be all facilities and centers serving to low income patients and families. I just wonder if wider networks will necessarily correlate to improved quality of care.
Again, this is one of those mandates that are going to make most of the population worse and only benefit a few. Instead of encouraging good hospitals to receive poor patients, the government is forcing the American population to attend a poor hospital or “essential community providers”.
There is a race to the bottom going on, and the losers will be every patient and potential patient in America.
“During the 2008 election, every serious candidate for the Democratic presidential nomination repeated the “universal coverage” mantra repeatedly ― and on the left “universal coverage” means universal access to care. I don’t recall any candidate talking about the benefits package. Also, no candidate even hinted that access to providers might not be any better than it is under Medicaid.”
Exactly right. Not only that, people thought their health care was going to be free!
People were shamefully tricked into voting for the Democratic Party, they are now realizing the grave mistake they made.
Wider networks do not raise premiums if insurers pay all providers on the same fee schedule.
If a health insurer pay $1500 for cataract surgery, the way that car insurers pay $1500 for replacing two door panels on a Chevy Malibu, then why would wider networks raise premiums?
I guess I am arguing for indemnity benefits. If the insured patient decides to go to Cedars of Lebanon hospital that charges $4500 for cataract surgery, they will have to pay $3000 out of pocket.
Once.
Then they and everyone they can talk to will stop using Cedars of Lebanon.
All you need to backstop this is a federal regulation on how much hospitals can charge for flat-on-your-back emergency care.
Bob Hertz, The Health Care Crusade