Obamacare Plans Offer 34 Percent Fewer Choices

Obamacare Plans Offer 34 Percent Fewer Choices

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By Suelain Moy

As many predicted, Americans insured under the Affordable Care Act may not be able to keep their doctors--and even their hospitals.

A new study reveals that the average plans provided on the Obamacare health insurance exchanges offer 34 percent fewer providers than the average commercial plan offered outside the exchange.

The analysis from Avalere shows the disparity compared with commercial plans:  

  • 42 percent fewer oncology and cardiology specialists
  • 32 percent fewer mental health and primary care providers
  • 24 percent fewer hospitals

Related: Top 10 Questions Consumers Ask About Obamacare

Exchange Plans

“Patients should evaluate a plan’s provider network when picking insurance on the exchange,” said Elizabeth Carpenter, vice president at Avalere. “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.”

Patients need to evaluate a plan’s provider network when selecting insurance on the exchange, especially if they have a history of cancer or heart disease or require mental health services.

Limiting choice is one way for health exchanges to keep costs down, but ultimately patients bear the cost. “Plans continue to test new benefit designs in the exchange market,” said Dan Mendelson, CEO at Avalere. “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.”

Stat of the Day: 0.2%

U.S. President Donald Trump at the White House in Washington, U.S. January 23, 2018.  REUTERS/Jonathan Ernst
Jonathan Ernst
By The Fiscal Times Staff

The New York Times’ Jim Tankersley tweets: “In order to raise enough revenue to start paying down the debt, Trump would need tariffs to be ~4% of GDP. They're currently 0.2%.”

Read Tankersley’s full breakdown of why tariffs won’t come close to eliminating the deficit or paying down the national debt here.

Number of the Day: 44%

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By The Fiscal Times Staff

The “short-term” health plans the Trump administration is promoting as low-cost alternatives to Obamacare aren’t bound by the Affordable Care Act’s requirement to spend a substantial majority of their premium revenues on medical care. UnitedHealth is the largest seller of short-term plans, according to Axios, which provided this interesting detail on just how profitable this type of insurance can be: “United’s short-term plans paid out 44% of their premium revenues last year for medical care. ACA plans have to pay out at least 80%.”

Number of the Day: 4,229

U.S. President Trump delivers remarks in Washington
JONATHAN ERNST/REUTERS
By The Fiscal Times Staff

The Washington Post’s Fact Checkers on Wednesday updated their database of false and misleading claims made by President Trump: “As of day 558, he’s made 4,229 Trumpian claims — an increase of 978 in just two months.”

The tally, which works out to an average of almost 7.6 false or misleading claims a day, includes 432 problematics statements on trade and 336 claims on taxes. “Eighty-eight times, he has made the false assertion that he passed the biggest tax cut in U.S. history,” the Post says.

Number of the Day: $3 Billion

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By The Fiscal Times Staff

A new analysis by the Department of Health and Human Services finds that Medicare’s prescription drug program could have saved almost $3 billion in 2016 if pharmacies dispensed generic drugs instead of their brand-name counterparts, Axios reports. “But the savings total is inflated a bit, which HHS admits, because it doesn’t include rebates that brand-name drug makers give to [pharmacy benefit managers] and health plans — and PBMs are known to play games with generic drugs to juice their profits.”

Chart of the Day: Public Spending on Job Programs

Martin Rangel, a worker at Bremen Castings, pours motel metal into forms on the foundry’s production line in Bremen
STAFF
By The Fiscal Times Staff

President Trump announced on Thursday the creation of a National Council for the American Worker, charged with developing “a national strategy for training and retraining workers for high-demand industries,” his daughter Ivanka wrote in The Wall Street Journal. A report from the president’s National Council on Economic Advisers earlier this week made it clear that the U.S. currently spends less public money on job programs than many other developed countries.