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.”

Tweet of the Day: The Black Hole of Big Pharma

A growing number of patients are being denied access to newer oral chemotherapy drugs for cancer pills with annual price tags of more than $75,000.
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By The Fiscal Times Staff

Billionaire John D. Arnold, a former energy trader and hedge fund manager turned philanthropist with a focus on health care, says Big Pharma appears to have a powerful hold on members of Congress.

Arnold pointed out that PhRMA, the main pharmaceutical industry lobbying group, had revenues of $459 million in 2018, and that total lobbying on behalf of the sector probably came to about $1 billion last year. “I guess $1 bil each year is an intractable force in our political system,” he concluded.

Warren’s Taxes Could Add Up to More Than 100%

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By The Fiscal Times Staff

The Wall Street Journal’s Richard Rubin says Elizabeth Warren’s proposed taxes could claim more than 100% of income for some wealthy investors. Here’s an example Rubin discussed Friday:

“Consider a billionaire with a $1,000 investment who earns a 6% return, or $60, received as a capital gain, dividend or interest. If all of Ms. Warren’s taxes are implemented, he could owe 58.2% of that, or $35 in federal tax. Plus, his entire investment would incur a 6% wealth tax, i.e., at least $60. The result: taxes as high as $95 on income of $60 for a combined tax rate of 158%.”

In Rubin’s back-of-the-envelope analysis, an investor worth $2 billion would need to achieve a return of more than 10% in order to see any net gain after taxes. Rubin notes that actual tax bills would likely vary considerably depending on things like location, rates of return, and as-yet-undefined policy details. But tax rates exceeding 100% would not be unusual, especially for billionaires.

Biden Proposes $1.3 Trillion Infrastructure Plan

FILE PHOTO: U.S. Democratic presidential candidate and former Vice President Joe Biden campaigns for the 2020 Democratic presidential nomination in Pittsburgh
Aaron Josefczyk
By Yuval Rosenberg

Joe Biden on Thursday put out a $1.3 trillion infrastructure proposal. The 10-year “Plan to Invest in Middle Class Competitiveness” calls for investments to revitalize the nation’s roads, highways and bridges, speed the adoption of electric vehicles, launch a “second great railroad revolution” and make U.S. airports the best in the world.

“The infrastructure plan Joe Biden released Thursday morning is heavy on high-speed rail, transit, biking and other items that Barack Obama championed during his presidency — along with a complete lack of specifics on how he plans to pay for it all,” Politico’s Tanya Snyder wrote. Biden’s campaign site says that every cent of the $1.3 trillion would be paid for by reversing the 2017 corporate tax cuts, closing tax loopholes, cracking down on tax evasion and ending fossil-fuel subsidies.

Read more about Biden’s plan at Politico.

Number of the Day: 18 Million

Win McNamee/Getty Images
By The Fiscal Times Staff

There were 18 million military veterans in the United States in 2018, according to the Census Bureau. That figure includes 485,000 World War II vets, 1.3 million who served in the Korean War, 6.4 million from the Vietnam War era, 3.8 million from the first Gulf War and another 3.8 million since 9/11. We join with the rest of the country today in thanking them for their service.

Chart of the Day: Dem Candidates Face Their Own Tax Plans

Senator Bernie Sanders, former Vice President Joe Biden and Senator Elizabeth Warren participate in the 2020 Democratic U.S. presidential debate in Houston
MIKE BLAKE/Reuters
By The Fiscal Times Staff

Democratic presidential candidates are proposing a variety of new taxes to pay for their preferred social programs. Bloomberg’s Laura Davison and Misyrlena Egkolfopoulou took a look at how the top four candidates would fare under their own tax proposals.