2014
This falls under the I want it all category and the consequences are quite predictable. One has to wonder if regulators have a clue as to the interaction between the parts of our health care system.
The idea that we can have affordable health insurance and at the same time unrestricted access to health care from any provider we choose is laughable. We expect insurance companies to negotiate the lowest possible prices which to do so requires leverage over providers; trading lower costs for a steady stream of potential patients and at the same time we don’t want limited networks of health care providers.
To date Obamacare has: 🔸mandated new benefits 🔸thrown out underwriting rules 🔸limited administrative costs as a percentage of premiums and now 🔸will regulate provider networks
At the same time state regulators pressured insurers into lower and lower premiums in the ACA exchanges even in light of the relatively unknown risks being incurred for 2014.
And you think all this will lead to lower, more affordable health insurance premiums?😆 Sooner or later all these counterproductive moves will come together, probably for 2015, and we will see what feel good political tinkering with the health care system really costs. Everyone wants the best; nobody wants to pay for it.
Insurers are facing pressure from regulators and lawmakers about plans that offer limited choices of doctors and hospitals, a tactic the industry said is vital to keep down coverage prices in the new health law’s marketplaces.
This week, federal regulators proposed a tougher review process for the doctors and hospitals in plans to be sold next year through HealthCare.gov, a shift that could force insurers to expand those networks.
Meantime, regulators in states including Washington and New Hampshire are ramping up their own scrutiny, and lawmakers in Mississippi and Pennsylvania, among others, are weighing bills that could force plans to add more hospitals and doctors.
Under the new federal proposal, insurers selling plans in the federally run marketplace would be required to submit to the Centers for Medicare and Medicaid Services a full list of providers in a network before their plans are approved for listing in the exchanges.
In the future, regulators also plan to develop federal standards for the required number of providers. For this year, the federal exchange relied largely on state regulators and third-party organizations to review networks, said Karen Pollitz, a senior fellow at the Kaiser Family Foundation.
via Insurers Face New Pressure Over Limited Doctor Choice – WSJ.com.
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