Obamacare Architect: If You Like Your Doctor, You Can Pay More | The Weekly Standard.
“It’s a simple yes or no question. Did he say if you like your doctor, you can keep your doctor?”
“Yes. But look, if you want to pay more for an insurance company that covers your doctor, you can do that. This is a matter of choice. We know in all sorts of places you pay more for certain — for a wider range of choices or wider range of benefits.The issue isn’t the selective networks. People keep saying, Oh, the problem is you’re going to have a selective network–“
The old “junk” plans had nationwide networks. The most important part of shopping aside from affordability is if your health care providers in-network. In Colorado, prior to Obamacare, this was RARELY a problem, not it’s a large problem.
From what I heard on The Kelly File, from someone who used to be with CMS, what Emanuel said isn’t true in most states. Even if you buy the “gold” plan, instead of the “bronze,” it doesn’t expand your network at all. It just reduces your deductible and co-pays. In fact in many ways there’s no difference between the plans, because they’re all set by gov’t policy anyway. Another thing he pointed out is that the formularies for prescription drugs can be reduced as well, depending on what plan you pick. So people may end up losing drug coverage, in addition to losing coverage for their hospital, and doctor, because of this.
Mark, in general that is true. The reality is slightly more complex but anyone shopping for an ACA compatible plan should start with looking for doctors and facilities they use to make sure they are in-network. The drug formulary should also be checked.
Other major issues are the networks from the plans available on the Exchange are primarily state based, so if you are out of state you are out of network except for emergencies. In Colorado, exceptions are Rocky Mountain Health Plan PPO options and Cigna (which is only available in the Denver area) which have nationwide networks.
Off the exchange, Assurant health has a nationwide network, but you can’t receive a subsidy when you purchase their plans.