Narrow choices for doctors and hospitals could keep costs down but add to consumer concerns

The Associated Press offers examples of limited networks that exclude some of the most prestigious hospitals in the Chicago and New York City areas.

The Washington Post: Insurers Restricting Choice Of Doctors And Hospitals To Keep Costs Down
As Americans have begun shopping for health plans on the insurance exchanges, they are discovering that insurers are restricting their choice of doctors and hospitals in order to keep costs low, and that many of the plans exclude top-rated hospitals. The Obama administration made it a priority to keep down the cost of insurance on the exchanges, the online marketplaces that are central to the Affordable Care Act. But one way that insurers have been able to offer lower rates is by creating networks that are far smaller than what most Americans are accustomed to (Somashekhar and Cha, 11/20).

The Associated Press/Washington Post: Next Worry: Narrow Choice Of Hospitals And Doctors Seen In New Health Overhaul Insurance Plans
After they get the website fixed, then what? Keeping your doctors and hospitals may be the next vexing challenge for Americans in the new health plans created by President Barack Obama's law. Obama promised people could keep their doctors. But in many states the new plans appear to offer a narrow choice of hospitals and doctors. Overall, it's shaping up as less choice than what people get through Medicare or employer-based coverage. Also, it can get complicated tracking down which medical providers are in what plans (11/20).

The Associated Press/Washington Post: New Health Plans Sold Through Exchanges Not Accepted At Some Prestigious NYC Hospitals
New Yorkers buying a health plan on the state's new insurance exchange should read the fine print if they're interested in getting care at some of the city's top hospitals. Not all are participating in the new plans created by the Affordable Care Act (11/20).

The Associated Press: Many Exchange Health Plans Exclude Top Hospitals
Chicago's best known hospitals don't accept many of the health plans sold on the new insurance marketplace that's part of the nation's health care law, and consumer advocates are worried patients will get stuck with unexpected bills. It may turn into the next big challenge for the insurance system created by President Barack Obama's law. Obama promised Americans could keep their doctors (Johnson, 11/20).

Meanwhile, on the small business front --

The Wall Street Journal: For Small Businesses, A Hidden Tax In Health Care?
Starting next year, small businesses are among those poised to bear the brunt of a little known tax created by the Affordable Care Act that will impose an annual "fee" on health-insurance companies. The fee is expected to bring in a total of $8 billion next year and as much as $14.3 billion by 2018, according to the legislation, and will be spread out among insurers based on the percent of the market they cover. But the Congressional Budget Office and industry experts say the expense will largely be passed on to small businesses and consumers who buy their own policies in the form of higher premiums (Needleman, 11/20).