Narrow Networks in Exchanges

[ABC]

I have been talking about Narrow Networks for the last year.

The majority of people will not care because they are only paying 5.6% of household income for health insurance. That is a much lower than what they are paying now for family coverage.

The people with means will not go for a HMO look a like.
That will be about 20% of the population that does not have access to large group.

Here is the other kicker that I predict. State that do not expand medicaid will shift those people over the exchange. Yeah they will have to pay 1.5% of household income for a policy but with additional tax credits for claims the AC could be 90+%. This will take the burden away from the states. These people will not care if they can only go to one hospital.

 

[Yagents]

I have been talking about Narrow Networks for the last year.

The majority of people will not care because they are only paying 5.6% of household income for health insurance. That is a much lower than what they are paying now for family coverage.

The people with means will not go for a HMO look a like.
That will be about 20% of the population that does not have access to large group.

Here is the other kicker that I predict. State that do not expand medicaid will shift those people over the exchange. Yeah they will have to pay 1.5% of household income for a policy but with additional tax credits for claims the AC could be 90+%. This will take the burden away from the states. These people will not care if they can only go to one hospital.

I'm under the impression that if the state does not roll out medicaid, and you're under 133% of FPL, you canNOT buy on the exchange, nor get tax credits. You can buy off the exchange at full price, but they won't/can't. These people fall into a "black hole".

 

[ABC]

I'm under the impression that if the state does not roll out medicaid, and you're under 133% of FPL, you canNOT buy on the exchange, nor get tax credits. You can buy off the exchange at full price, but they won't/can't. These people fall into a "black hole".

This is a good point but I hear Arkansas is working on a deal move these people to the exchange.

It will be interesting what the bench mark for the subsidies will be after everything is said and done,

 

[wyche1]

PA's are going to be the PCP of the future. I do expect the entire program to implode within 36 months basically near the end of Obama's reign. the subsidies/tax credits figures that I have seen will not pick up enough of the increase in premiums for the middle class. Even liberals will revolt (they hate paying for others more than anyone else), they will go uninsured and pay the penalty or not file tax returns. I honestly believe the problems will be so huge that as a country (via elections) we will have to abandon the ACA or go 100% universal healthcare and have huge tax increases. There may even be some good that comes out of this, but it won't be my income over the next 4 years.

2 daughters in college wanting to be PA's, HELP US ALL!!

 

[Yagents]

They can't let these folks fall into a black hole

States Seek to Direct Medicaid Patients to Exchanges - Bloomberg


Lower-income residents eligible for Medicaid may be directed to buy coverage from health insurance exchanges using tax dollars, an option the Obama administration is weighing.

 

[AllenChicago]

October 29, 2014

A very popular, local physician said today that he is dropping out of the BCBS-IL "Choice" PPO network at the end of this year because the ObamaScare technical mandates, combined with the low-reimbursement of the Choice network are threatening to put him out of business.

Over the Summer, he was required to purchase $97,000 of new computer hardware, software, and licenses to comply with some patient-data requirement that goes into effect in 2015. The system works so poorly that he has to keep shelling out money to I.T. consultants for patches.

Bottom Line is that our state's largest insurer's lowest priced PPO network will be losing another really good physician at the end of this year. Unfortunately, ObamaScare is continuing it's push to prepare this country for Medicare-for-all, exactly as planned.
ac


Sidebar: BCBS-IL has 3 Medical Provider Networks.
1. PPO - Highest Cost Plans - Widest Network - +95% Provider Participation.
2. HMO - Medium Cost Plans - Network is 30% smaller than PPO.
3. CHOICE PPO - Lowest Cost Plans - Network is 70% smaller than PPO.

(#3 should be called "Little Choice" PPO.)

 

[somarco]

Over 214,000 doctors won't participate in the new plans under the Affordable Care Act (ACA,) analysis of a new survey by Medical Group Management Association shows. That number of 214,524, estimated by American Action Forum, is through May 2014, but appears to be growing due to plans that force doctors to take on burdensome costs. It's also about a quarter of the total number of 893,851 active professional physicians reported by the Kaiser Family Foundation.

In January, an estimated 70% of California's physicians were not participating in Covered California plans.

Over 214,000 Doctors Opt Out of Obamacare Exchanges | CNS News

 

[Yagents]

My question is.......is anyone seeing this with off exchange p.p.o plan networks. I'm considering dropping my grandfathered plan this year as the price is the same with better benefits with a.c.a plan

 

[taterpeeler]

My question is.......is anyone seeing this with off exchange p.p.o plan networks. I'm considering dropping my grandfathered plan this year as the price is the same with better benefits with a.c.a plan

what...what... better bennies with aca plans.... you mean fox news has been wrong all this time?.... or lord Jesus take me now

 

[kgmom219]

My question is.......is anyone seeing this with off exchange p.p.o plan networks. I'm considering dropping my grandfathered plan this year as the price is the same with better benefits with a.c.a plan

Nope. But I am wary of anything until after we see the 2015 plans in black and white.

Something to keep in the mind on the "narrow" networks. If these are people who were truly uninsured prior to ACA, they may not care. Assuming they can see their PCP, this is WAY better than they had prior to ACA. It may be a crap network to us, but to someone who had only previously been to the "county hospital", the new network is fabulous. I don't have a lot of subsidy clients, but I will never forget the woman who started crying hysterically when she found out she didn't have to deliver her baby at Parkland.