Benefit Shock

As Robert Laszewski has observed, the health care media has been obsessed with whether or not premiums in the ObamaCare exchanges will produce “rate shock.” They have completely ignored the more likely source of discomfort — especially for people used to employer plans that allow access to almost any doctor or hospital.

The big surpriseOB-UE291_goodma_G_20120814172119 here will be that in many states that second-lowest cost plan [the one that qualifies for a full subsidy] will be a narrow-network plan with significant limits on which providers the consumer can go to. In fact, in many cases, the narrow-network plan will look very much like a Medicaid network.

In California, for example, the Blue Shield exchange offering is limited to 24,000 doctors compared to the standard Blue Shield network that covers 64,000 docs.

The lowest cost California plan comes from insurer Health Net. The LA Times is reporting that Health Net is offering, “less than half what some other companies are offering in Southern California.” The Times reports that Health Net is limiting its network to one-third its usual employer network. In San Diego, the company will only have 204 primary care physicians in its network.

In New Hampshire, the sole health plan offered on the exchange is a WellPoint plan, which will cover only 14 of 26 state hospitals and 65% of the normal physician network.

See previous posts on then race to the bottom within the exchanges here, here, here and here.

Comments (15)

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  1. Sean Parnell says:

    Another shock will be ‘deductible shock’ – when all those people sign up for their ‘free’ healthcare and discover that the policy they can afford comes with a $2,500 or $5,000 deductible (Silver, Bronze), which they’ve been told isn’t ‘real’ insurance. I keep reading how health exchange officials are trying to get the young to buy health insurance by telling them they might ski into a tree. Unless it’s a really, really bad accident (i.e. a lot more than just a broken leg or arm), they’re financially probably better off uninsured, because their choices are basically pay $5,000 for care as an uninsured patient, or pay $5,000 for care AND pay $1,500 in insurance premiums.

    • Crawford says:

      Interesting point, Sean. Since young people, the healthy one’s who are the “cash cows” for insurance companies, would be financially better off uninsured, insurance companies will be left with the people who drain the insurance companies of funds.

      Why did congress allow this plan to even be mentioned on the floor? This is the start of a very, very large mess.

      • Rutledge says:

        Since there’s no telling what is going to happen to my insurance rates, I think I need to just “buddy up” with a doctor at my country club and offer to pay for a round of 18 once a year. This will leave for plenty of time for me to ask a few health questions. Might just need to tell the cart-girl to not bring me the usual bucket of refreshments as often, during that round.

    • JD says:

      You’re right. People have no idea what is going to happen. Yet, I see the shocks being blamed on Republicans.

  2. JD says:

    This will be a shock to many people, but it seems like it will be too late at that point.

    • Crawford says:

      I read that Obama has limited the funds for advertising this plan until after it is released. Many will not know what kind of can of worms we just opened until nearly Halloween.

  3. Dewaine says:

    You have to pay somehow. The more “free” it is, the more “other” problems you’ll have.

  4. Crawford says:

    “In New Hampshire, the sole health plan offered on the exchange is a WellPoint plan, which will cover only 14 of 26 state hospitals and 65% of the normal physician network.”

    What are the other 35% going to do? Cash only?