Plan renewals, narrow networks draw scrutiny

Published on July 29, 2014 at 2:57 AM · No Comments

Some industry officials say the automatic renewal of some health law insurance plans could have a negative impact on the financial aid that consumers receive. Meanwhile, narrow networks continue to be the subject of backlash.

The Associated Press: Plan To Simplify 2015 Health Renewals May Backfire
If you have health insurance on your job, you probably don't give much thought to each year's renewal. But make the same assumption in one of the new health law plans, and it could lead to costly surprises. Insurance exchange customers who opt for convenience by automatically renewing their coverage for 2015 are likely to receive dated and inaccurate financial aid amounts from the government, say industry officials, advocates and other experts (Alonso-Zaldivar, 7/27).

Kaiser Health News: Limitations Of New Health Plans Rankle Some Enrollees
Nancy Pippenger and Marcia Perez live 2,000 miles apart but have the same complaint: Doctors who treated them last year won't take their insurance now, even though they haven't changed insurers. … In Plymouth, Ind., Pippenger got similar news from her longtime orthopedic surgeon, so she shelled out $300 from her own pocket to see him. Both women unwittingly bought policies with limited networks of doctors and hospitals that provide little or no payment for care outside those networks. Such plans existed before the health law, but they've triggered a backlash as millions start to use the coverage they signed up for this year through the new federal and state marketplaces. The policies' limitations have come as a surprise to some enrollees used to broader job-based coverage or to plans they held before the law took effect (Appleby, 7/28). 

Des Moines Register: Few Take Chance To Gripe About Health Insurance
Public hearings over proposed premium increases by three health insurers drew a grand total of two Iowans who wanted to take the microphone to gripe Saturday morning. "I figured there'd be more people. Evidently, people don't care about this," said Ed Tiernan of Des Moines, one of the two consumers who bothered to speak. In past years, dozens of Iowans took the chance to complain publicly about large rate increases proposed by the state's dominant health insurer, Wellmark Blue Cross & Blue Shield. But that was not the case Saturday morning, when state Insurance Commissioner Nick Gerhart presided over hearings centering on proposed premium increases from Coventry Health Care, CoOportunity Health and Assurant Health. About 24,000 Iowans would be affected by the three companies' rate increases. Most of them are covered by Coventry or CoOportunity, which are the main Iowa carriers selling policies on the new electronic marketplace set up under the Affordable Care Act (Leys, 7/26). 

Denver Post: Coloradans Could Lose Medical Choices, But Save Money
Consumers might not like the trend among insurance carriers to control costs and reduce premiums by narrowing their choices of doctors and hospitals, but it's one of the few tools that payers have left. Under the Affordable Care Act, insurers can't cut costs by discriminating against people with pre-existing conditions. They can't offer spare coverage because health care reform mandates minimum essential elements. Instead, insurers or payers are turning to narrow or "high value" networks to reduce escalating health care costs. The narrow network gives insurers greater leverage in negotiating prices with providers. ... United Healthcare, the largest Medicare provider in the country, said it is reducing its Medicare physician network in the Denver market -; letters went out last week telling customers they might need to select a new physician (Draper, 7/27). 


http://www.kaiserhealthnews.orgThis article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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