Obamacare Plans Illuminate High Cost of Going 'Out of Network'
Why Narrow Networks May Not Be Such A Bad Idea
Obamacare to Force Millions to Upgrade Insurance
California Insurance Chief: Bar Anthem from Small Business Marketplace
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(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Consumers learn that in some cases there is no maximum on out-of-pocket costs if they see out-of-network providers. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-style: italic;color: #000000\">Editor's note: This post is part of the ongoing \u003c/span>\u003ca style=\"font-style: italic;color: #000000\" href=\"http://centerforhealthreporting.org/project/answers-consumer-questions-about-obamacare\" target=\"_blank\">Ask Emily\u003c/a>\u003cspan style=\"font-style: italic;color: #000000\"> column, a project of the nonprofit CHCF Center for Health Reporting. Reporter Emily Bazar answers consumer questions about Obamacare. In this issue, Bazar takes a look at the potential costs of visiting an out-of-network doctor or other provider. This is an issue anyone \u003c/span>\u003ci>with\u003c/i>\u003cspan style=\"color: #000000\">\u003ci> health insurance should pay attention to.\u003c/i>\u003c/span>\u003c/p>\n\u003cp style=\"color: #000000\">\u003cstrong>Q: I learned today that the health “insurance” I purchased for my family through Covered California does not have ANY maximum out-of-pocket cost on out-of-network providers. … How is that even possible? Our family is now faced with potentially infinite costs that could wipe us out.\u003c/strong>\u003c/p>\n\u003cp style=\"color: #000000\">A: Let’s start with a quick refresher.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Consumer learns there is no maximum on what she must pay for out-of-network doctors she saw.\u003c/aside>\n\u003cp style=\"color: #000000\">An \u003ca class=\"ext\" style=\"color: #5d93b3\" href=\"https://www.coveredca.com/glossary/\" target=\"_blank\">out-of-pocket maximum\u003c/a> is the most you would pay during the term of your health policy (usually one year) before your insurance begins paying 100 percent of covered medical services.\u003c/p>\n\u003cp style=\"color: #000000\">Deductibles, co-pays and other costs generally count toward your out-of-pocket maximum. Your monthly premiums don’t.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp style=\"color: #000000\">This year, Obamacare \u003ca class=\"ext\" style=\"color: #5d93b3\" href=\"http://www.kaiserhealthnews.org/Features/Insuring-Your-Health/2013/061113-Michelle-Andrews-out-of-pocket-costs.aspx\" target=\"_blank\">capped\u003c/a> out-of-pocket maximums at $6,350 for an individual policy and $12,700 for a family policy.\u003c/p>\n\u003cp style=\"color: #000000\">Maureen Burke of Berkeley, who submitted the question above, settled on a Blue Shield EPO (\u003ca class=\"ext\" style=\"color: #5d93b3\" href=\"https://www.healthcare.gov/glossary/exclusive-provider-organization-EPO-plan/\" target=\"_blank\">Exclusive Provider Organization\u003c/a>) family plan from \u003ca class=\"ext\" style=\"color: #5d93b3\" href=\"https://www.coveredca.com/\" target=\"_blank\">Covered California\u003c/a> with a $12,700 out-of-pocket maximum.\u003c/p>\n\u003cp style=\"color: #000000\">It wasn’t until recently that Burke realized that those much-publicized out-of-pocket maximums –-including hers –- only apply to services obtained from medical providers IN the plan’s network.\u003c/p>\n\u003cp style=\"color: #000000\">So what about providers who are not in network? Were limits set on those costs?\u003c/p>\n\u003cp style=\"color: #000000\">In her case, to her shock, no.\u003c/p>\n\u003cp style=\"color: #000000\">As it turns out, insurers get to decide the dollar limits –- if any –- for themselves.\u003c/p>\n\u003cp style=\"color: #000000\">“The out-of-network, out-of-pocket costs for each plan would be at the plans’ discretion,” says Covered California spokesman Roy Kennedy. “You would need to inquire with the individual plans on what their policy is for out-of-network costs.”\u003c/p>\n\u003cp style=\"color: #000000\">What’s the big deal, you may be wondering. Burke and others should just stay in their networks, right?\u003c/p>\n\u003cp style=\"color: #000000\">\u003cstrong>Challenge in Determining If A Doctor is \"In Network\"\u003c/strong>\u003c/p>\n\u003cp style=\"color: #000000\">In this new health insurance environment, that’s easier said that done.\u003c/p>\n\u003cp style=\"color: #000000\">As many of you know, insurers have created “narrow networks” for many of their new plans. In plain terms, that means they have whittled down the number of participating doctors and hospitals. The providers agree to charge insurers lower fees in return for higher volumes of patients.\u003c/p>\n\u003cp style=\"color: #000000\">But for consumers, staying in network has become more difficult because there are fewer providers serving more patients.\u003c/p>\n\u003cp style=\"color: #000000\">(Good luck confirming whether your doctor and hospital are in network.\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/02/11/youre-enrolled-in-an-obamacare-plan-will-your-doctor-accept-your-insurance/\" target=\"_blank\"> Misinformation and inaccuracies\u003c/a> have plagued the network lists since the beginning.)\u003c/p>\n\u003cp style=\"color: #000000\">Burke poses a hypothetical: What if she needs surgery? She’ll make sure her doctor and hospital are in network. But, she notes, they won’t be the only ones providing services.\u003c/p>\n\u003cp style=\"color: #000000\">“One can’t know during surgery whether the assistant surgeon, the radiologist, the anesthesiologist, etc., are in network or not,” she says.\u003c/p>\n\u003cp style=\"color: #000000\">This doesn’t apply just to Covered California plans. Priscilla Myrick, also of Berkeley, bought an Anthem Blue Cross PPO (\u003ca class=\"ext\" style=\"color: #5d93b3\" href=\"http://www.ehealthinsurance.com/health-plans/ppo/\" target=\"_blank\">Preferred Provider Organization\u003c/a>) family plan on the private market.\u003c/p>\n\u003cp style=\"color: #000000\">Earlier this year, she visited the cardiologist she used to see through her previous Anthem plan and had a mammogram and bone density test at an imaging center that used to be in network.\u003c/p>\n\u003cp style=\"color: #000000\">Then she opened her mailbox and found bills totaling more than $1,500.\u003c/p>\n\u003cp style=\"color: #000000\">Myrick started digging. She learned that her cardiologist and imaging center are no longer in her network, which sent her bills skyrocketing.\u003c/p>\n\u003cp style=\"color: #000000\">Then she discovered that Anthem would assume all costs for covered services outside its network only after she had paid $30,000 out of her own pocket.\u003c/p>\n\u003cp style=\"color: #000000\">Myrick is a retired certified public accountant. “I know how to look at numbers,” she says.\u003c/p>\n\u003cp style=\"color: #000000\">But that one had not been apparent when she shopped around for plans. “How was anyone supposed to know this?” she asks.\u003c/p>\n\u003cp style=\"color: #000000\">Myrick has since cancelled a follow-up procedure ordered by the cardiologist because “I couldn’t find out how much it was going to cost,” she says.\u003c/p>\n\u003cp style=\"color: #000000\">(Find Myrick’s complaint letter to the Covered California board \u003ca class=\"ext\" style=\"color: #5d93b3\" href=\"http://board.coveredca.com/meetings/2014/04%20Apr%20Meeting%20Materials/PDFs/MASTER%20Comments%20to%20the%20Board%20-%20Table%20of%20Contents_April%2017,%202014.pdf\" target=\"_blank\">here\u003c/a>.)\u003c/p>\n\u003cp style=\"color: #000000\">Darrel Ng, an Anthem spokesman, says out-of-pocket maximums for out-of-network providers range from $10,000 to $18,000 for the company’s individual plans and $20,000 to $36,000 for family plans on the private market. On Covered California, they range from $10,000 to $15,000 for individuals, he says, and from $20,000 to $30,000 for families.\u003c/p>\n\u003cp style=\"color: #000000\">He urges consumers to do their homework before getting care, if possible, to ensure their providers are in network.\u003c/p>\n\u003cp style=\"color: #000000\">“We would encourage them to contact the hospital and find out whether all the different parts of the medical system they’ll be touching are in their network and ask, if possible, that in-network providers be used,” Ng says.\u003c/p>\n\u003cp style=\"color: #000000\">Once again, easier said than done. How will the hospital know which radiologist or pathologist or fill-in-the-blank-ologist will be working at the time of your surgery one month from now?\u003c/p>\n\u003cp style=\"color: #000000\">“Who would answer those questions? The receptionist at the hospital?” Burke asks. “It’s impossible.”\u003c/p>\n\u003cp style=\"color: #000000\">I tend to agree.\u003c/p>\n\u003cp style=\"color: #000000\">Here’s my advice: Find out what your limit is for out-of-network providers.\u003c/p>\n\u003cp style=\"color: #000000\">And hope like heck that you don’t need them.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"rC8rKUPYtGTs42rqdnohzRA7MlZkxYd3\"]\u003c/p>\n\n","blocks":[],"excerpt":"Under Obamacare, in-network maximum is capped at $6,350 for an individual. But out-of-network maximums may be much higher, even unlimited.","status":"publish","parent":0,"modified":1400187649,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":4,"wordCount":1023},"headData":{"title":"Obamacare Plans Illuminate High Cost of Going 'Out of Network' | KQED","description":"Under Obamacare, in-network maximum is capped at $6,350 for an individual. But out-of-network maximums may be much higher, even unlimited.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"19063 http://blogs.kqed.org/stateofhealth/?p=19063","disqusUrl":"https://ww2.kqed.org/stateofhealth/2014/05/08/obamacare-plans-illuminate-high-cost-of-going-out-of-network/","disqusTitle":"Obamacare Plans Illuminate High Cost of Going 'Out of Network'","path":"/stateofhealth/19063/obamacare-plans-illuminate-high-cost-of-going-out-of-network","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19066\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/179324294-e1399567436110.jpg\">\u003cimg class=\"size-large wp-image-19066\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/179324294-640x426.jpg\" alt=\"Consumers learn that in some cases there is no maximum on out-of-pocket costs if they see out-of-network providers. (Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Consumers learn that in some cases there is no maximum on out-of-pocket costs if they see out-of-network providers. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-style: italic;color: #000000\">Editor's note: This post is part of the ongoing \u003c/span>\u003ca style=\"font-style: italic;color: #000000\" href=\"http://centerforhealthreporting.org/project/answers-consumer-questions-about-obamacare\" target=\"_blank\">Ask Emily\u003c/a>\u003cspan style=\"font-style: italic;color: #000000\"> column, a project of the nonprofit CHCF Center for Health Reporting. Reporter Emily Bazar answers consumer questions about Obamacare. In this issue, Bazar takes a look at the potential costs of visiting an out-of-network doctor or other provider. This is an issue anyone \u003c/span>\u003ci>with\u003c/i>\u003cspan style=\"color: #000000\">\u003ci> health insurance should pay attention to.\u003c/i>\u003c/span>\u003c/p>\n\u003cp style=\"color: #000000\">\u003cstrong>Q: I learned today that the health “insurance” I purchased for my family through Covered California does not have ANY maximum out-of-pocket cost on out-of-network providers. … How is that even possible? Our family is now faced with potentially infinite costs that could wipe us out.\u003c/strong>\u003c/p>\n\u003cp style=\"color: #000000\">A: Let’s start with a quick refresher.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Consumer learns there is no maximum on what she must pay for out-of-network doctors she saw.\u003c/aside>\n\u003cp style=\"color: #000000\">An \u003ca class=\"ext\" style=\"color: #5d93b3\" href=\"https://www.coveredca.com/glossary/\" target=\"_blank\">out-of-pocket maximum\u003c/a> is the most you would pay during the term of your health policy (usually one year) before your insurance begins paying 100 percent of covered medical services.\u003c/p>\n\u003cp style=\"color: #000000\">Deductibles, co-pays and other costs generally count toward your out-of-pocket maximum. Your monthly premiums don’t.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp style=\"color: #000000\">This year, Obamacare \u003ca class=\"ext\" style=\"color: #5d93b3\" href=\"http://www.kaiserhealthnews.org/Features/Insuring-Your-Health/2013/061113-Michelle-Andrews-out-of-pocket-costs.aspx\" target=\"_blank\">capped\u003c/a> out-of-pocket maximums at $6,350 for an individual policy and $12,700 for a family policy.\u003c/p>\n\u003cp style=\"color: #000000\">Maureen Burke of Berkeley, who submitted the question above, settled on a Blue Shield EPO (\u003ca class=\"ext\" style=\"color: #5d93b3\" href=\"https://www.healthcare.gov/glossary/exclusive-provider-organization-EPO-plan/\" target=\"_blank\">Exclusive Provider Organization\u003c/a>) family plan from \u003ca class=\"ext\" style=\"color: #5d93b3\" href=\"https://www.coveredca.com/\" target=\"_blank\">Covered California\u003c/a> with a $12,700 out-of-pocket maximum.\u003c/p>\n\u003cp style=\"color: #000000\">It wasn’t until recently that Burke realized that those much-publicized out-of-pocket maximums –-including hers –- only apply to services obtained from medical providers IN the plan’s network.\u003c/p>\n\u003cp style=\"color: #000000\">So what about providers who are not in network? Were limits set on those costs?\u003c/p>\n\u003cp style=\"color: #000000\">In her case, to her shock, no.\u003c/p>\n\u003cp style=\"color: #000000\">As it turns out, insurers get to decide the dollar limits –- if any –- for themselves.\u003c/p>\n\u003cp style=\"color: #000000\">“The out-of-network, out-of-pocket costs for each plan would be at the plans’ discretion,” says Covered California spokesman Roy Kennedy. “You would need to inquire with the individual plans on what their policy is for out-of-network costs.”\u003c/p>\n\u003cp style=\"color: #000000\">What’s the big deal, you may be wondering. Burke and others should just stay in their networks, right?\u003c/p>\n\u003cp style=\"color: #000000\">\u003cstrong>Challenge in Determining If A Doctor is \"In Network\"\u003c/strong>\u003c/p>\n\u003cp style=\"color: #000000\">In this new health insurance environment, that’s easier said that done.\u003c/p>\n\u003cp style=\"color: #000000\">As many of you know, insurers have created “narrow networks” for many of their new plans. In plain terms, that means they have whittled down the number of participating doctors and hospitals. The providers agree to charge insurers lower fees in return for higher volumes of patients.\u003c/p>\n\u003cp style=\"color: #000000\">But for consumers, staying in network has become more difficult because there are fewer providers serving more patients.\u003c/p>\n\u003cp style=\"color: #000000\">(Good luck confirming whether your doctor and hospital are in network.\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/02/11/youre-enrolled-in-an-obamacare-plan-will-your-doctor-accept-your-insurance/\" target=\"_blank\"> Misinformation and inaccuracies\u003c/a> have plagued the network lists since the beginning.)\u003c/p>\n\u003cp style=\"color: #000000\">Burke poses a hypothetical: What if she needs surgery? She’ll make sure her doctor and hospital are in network. But, she notes, they won’t be the only ones providing services.\u003c/p>\n\u003cp style=\"color: #000000\">“One can’t know during surgery whether the assistant surgeon, the radiologist, the anesthesiologist, etc., are in network or not,” she says.\u003c/p>\n\u003cp style=\"color: #000000\">This doesn’t apply just to Covered California plans. Priscilla Myrick, also of Berkeley, bought an Anthem Blue Cross PPO (\u003ca class=\"ext\" style=\"color: #5d93b3\" href=\"http://www.ehealthinsurance.com/health-plans/ppo/\" target=\"_blank\">Preferred Provider Organization\u003c/a>) family plan on the private market.\u003c/p>\n\u003cp style=\"color: #000000\">Earlier this year, she visited the cardiologist she used to see through her previous Anthem plan and had a mammogram and bone density test at an imaging center that used to be in network.\u003c/p>\n\u003cp style=\"color: #000000\">Then she opened her mailbox and found bills totaling more than $1,500.\u003c/p>\n\u003cp style=\"color: #000000\">Myrick started digging. She learned that her cardiologist and imaging center are no longer in her network, which sent her bills skyrocketing.\u003c/p>\n\u003cp style=\"color: #000000\">Then she discovered that Anthem would assume all costs for covered services outside its network only after she had paid $30,000 out of her own pocket.\u003c/p>\n\u003cp style=\"color: #000000\">Myrick is a retired certified public accountant. “I know how to look at numbers,” she says.\u003c/p>\n\u003cp style=\"color: #000000\">But that one had not been apparent when she shopped around for plans. “How was anyone supposed to know this?” she asks.\u003c/p>\n\u003cp style=\"color: #000000\">Myrick has since cancelled a follow-up procedure ordered by the cardiologist because “I couldn’t find out how much it was going to cost,” she says.\u003c/p>\n\u003cp style=\"color: #000000\">(Find Myrick’s complaint letter to the Covered California board \u003ca class=\"ext\" style=\"color: #5d93b3\" href=\"http://board.coveredca.com/meetings/2014/04%20Apr%20Meeting%20Materials/PDFs/MASTER%20Comments%20to%20the%20Board%20-%20Table%20of%20Contents_April%2017,%202014.pdf\" target=\"_blank\">here\u003c/a>.)\u003c/p>\n\u003cp style=\"color: #000000\">Darrel Ng, an Anthem spokesman, says out-of-pocket maximums for out-of-network providers range from $10,000 to $18,000 for the company’s individual plans and $20,000 to $36,000 for family plans on the private market. On Covered California, they range from $10,000 to $15,000 for individuals, he says, and from $20,000 to $30,000 for families.\u003c/p>\n\u003cp style=\"color: #000000\">He urges consumers to do their homework before getting care, if possible, to ensure their providers are in network.\u003c/p>\n\u003cp style=\"color: #000000\">“We would encourage them to contact the hospital and find out whether all the different parts of the medical system they’ll be touching are in their network and ask, if possible, that in-network providers be used,” Ng says.\u003c/p>\n\u003cp style=\"color: #000000\">Once again, easier said than done. How will the hospital know which radiologist or pathologist or fill-in-the-blank-ologist will be working at the time of your surgery one month from now?\u003c/p>\n\u003cp style=\"color: #000000\">“Who would answer those questions? The receptionist at the hospital?” Burke asks. “It’s impossible.”\u003c/p>\n\u003cp style=\"color: #000000\">I tend to agree.\u003c/p>\n\u003cp style=\"color: #000000\">Here’s my advice: Find out what your limit is for out-of-network providers.\u003c/p>\n\u003cp style=\"color: #000000\">And hope like heck that you don’t need them.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"rC8rKUPYtGTs42rqdnohzRA7MlZkxYd3\"]\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/19063/obamacare-plans-illuminate-high-cost-of-going-out-of-network","authors":["8344"],"categories":["stateofhealth_15"],"tags":["stateofhealth_368","stateofhealth_542"],"featImg":"stateofhealth_19066","label":"stateofhealth"},"stateofhealth_16450":{"type":"posts","id":"stateofhealth_16450","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"16450","score":null,"sort":[1385662931000]},"guestAuthors":[],"slug":"why-narrow-networks-may-not-be-such-a-bad-idea","title":"Why Narrow Networks May Not Be Such A Bad Idea","publishDate":1385662931,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>\u003cstrong>By Dan Diamond\u003c/strong>, \u003ca href=\"http://www.californiahealthline.org/road-to-reform/2013/when-health-plans-drop-your-doctor-are-narrow-networks-a-bad-idea\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>Search Covered California's website, and you'll find a list of 33 \"frequently asked questions.\"\u003c/p>\n\u003cp>The 33rd and final question -- below questions like \"Why should I buy health insurance?\" and \"I'm pregnant and do not have insurance. What health coverage is available for me?\" -- is \u003ca href=\"https://www.coveredca.com/FAQs/#faq-27\" target=\"_blank\">this one\u003c/a>: \"Will patients be able to keep their same doctor when they purchase health insurance through Covered California?\"\u003c/p>\n\u003cp>The question may be last on Covered California's list, but it's top-of-mind for many consumers. About one million Californians, and \u003ca href=\"http://www.californiahealthline.org/road-to-reform/2013/how-many-people-are-losing-their-plans-under-obamacare-really\">millions of other Americans\u003c/a>, are losing their health plans through the individual market and turning to Obamacare's new insurance exchanges to shop for replacement coverage. And in many cases, it's still unclear if the family doctor will be coming with them.\u003c/p>\n\u003cp>\u003cstrong>The Mechanics Behind Narrow Networks\u003c!--more-->\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>This issue began to emerge back in May when Covered California announced its low premiums to some fanfare -- a \"home run\" for the state, officials \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/23/californias-health-insurance-exchange-sets-plans-premiums-no-apparent-rate-shock/\" target=\"_blank\">said at the time\u003c/a>.\u003c/p>\n\u003cp>But some critics seized on news that participating insurers had achieved those lower costs, in part, by \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/29/why-californias-obamacare-premiums-are-lower-than-expected/\" target=\"_blank\">relying on narrow networks\u003c/a> that excluded UCLA Medical Center and Cedars-Sinai Medical Center -- two of the state's most prominent, if expensive, hospitals.\u003c/p>\n\u003cp>Similar stories followed in other states, as exchanges released their rates and participating health care providers.\u003c/p>\n\u003cp>\"We knew it was going to be narrow,\" one Missouri insurance broker \u003ca href=\"http://www.kaiserhealthnews.org/stories/2013/september/26/narrow-insurance-network-missouri-exchange-marketplace.aspx\" target=\"_blank\">told \u003cem>Kaiser Health News\u003c/em>\u003c/a> after one local briefing. But the actual list of participating hospitals \"was kind of eye-opening.\"\u003c/p>\n\u003cp>The issue plays directly to one of the biggest fears sparked by the Affordable Care Act: The law will limit patient choice. But supporters say that's not the case.\u003c/p>\n\u003cp>\"Narrow networks may seem like a bad idea,\" David Dranove and Craig Garthwaite \u003ca href=\"http://dranove.wordpress.com/2013/10/22/broad-thinking-about-narrow-networks/\" target=\"_blank\">blogged last month\u003c/a>. The two Northwestern University professors acknowledged that excluding some providers from health plans offered through the exchanges runs the risk of disrupting care patterns.\u003c/p>\n\u003cp>But the model is \"not some cruel attempt to limit patient choice foisted upon us by the insurance industry,\" the professors added. \"Instead, these plans may provide our best opportunity for harnessing market forces to lower prices.\"\u003c/p>\n\u003cp>The simple equation: Insurers say that limiting the size of the network allows them to steer patients to high-quality facilities and doctors; participating providers, meanwhile, may agree to price cuts in exchange for new volumes.\u003c/p>\n\u003cp>And narrow networks aren't necessarily a new idea, Darius Tahir \u003ca href=\"http://www.nationaljournal.com/innovations-in-health/narrow-network-health-plans-expected-to-proliferate-under-obamacare-20131009\" target=\"_blank\">points out\u003c/a> at \u003cem>National Journal\u003c/em>. In some ways, it's the same concept behind payers' attempts in the 1980s and 1990s to limit their network size, which\u003ca href=\"http://www.managedcaremag.com/archives/0403/0403.narrow_networks.html\" target=\"_blank\"> met with criticism\u003c/a> and helped create \"Any Willing Provider\" laws.\u003c/p>\n\u003cp>Could narrow networks be better perceived -- and received -- with better phrasing? Industry consultant Vince Kuraitis thinks so.\u003c/p>\n\u003cp>\"The very term 'narrow network' creates a negative connotation and doesn't speak to potential benefits,\" \u003ca href=\"http://thehealthcareblog.com/blog/2013/10/22/in-defense-of-narrow-networks/comment-page-1/#comment-457059\" target=\"_blank\">Kuraitis comments\u003c/a> at The Health Care Blog. But choosing to describe \"the same networks as 'high-performance networks' or 'intelligent networks'... [t]he connotations here are much more positive.\"\u003c/p>\n\u003cp>\u003cstrong>Do Providers Want In? It's Complicated.\u003c/strong>\u003c/p>\n\u003cp>Some hospitals -- initially left out of exchange plans -- are fighting to be included.\u003c/p>\n\u003cul>\n\u003cli>Seattle Children's Hospital \u003ca href=\"http://seattletimes.com/html/localnews/2021968776_acachildrenssuitxml.html\" target=\"_blank\">sued the\u003c/a> state insurance commissioner, which helped \u003ca href=\"http://seattletimes.com/html/localnews/2022143835_acapremeraresponsexml.html\" target=\"_blank\">begin a battle\u003c/a>with a local insurer over whether the facility's rates are too high.\u003c/li>\n\u003cli>Eleven Kentucky hospitals have filed complaints; so far, the department has ordered Anthem to \u003ca href=\"http://www.courier-journal.com/article/20131124/BUSINESS/311240055/Kynect-policies-concern-eleven-Kentucky-hospitals?gcheck=1&nclick_check=1\" target=\"_blank\">accept applications\u003c/a> from three of those hospitals.\u003c/li>\n\u003c/ul>\n\u003cp>Yet many top facilities are \u003ca href=\"http://health.usnews.com/health-news/hospital-of-tomorrow/articles/2013/10/30/top-hospitals-opt-out-of-obamacare\" target=\"_blank\">choosing to opt out\u003c/a> of exchange plans.\u003c/p>\n\u003cp>And some doctors are sitting out, too, citing low reimbursement.\u003c/p>\n\u003cp>Presented with contracts that paid up to 30 percent less than traditional rates, \"we said, this doesn't make a whole lot of sense for us,\" Richard Thorp, president of the California Medical Association \u003ca href=\"http://online.wsj.com/news/articles/SB10001424052702304607104579212450545926912\" target=\"_blank\">told the \u003cem>Wall Street Journal\u003c/em>\u003c/a>.\u003c/p>\n\u003cp>Why? In part, prominent providers' doubts echo the concerns of \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/29/why-californias-obamacare-premiums-are-lower-than-expected/\" target=\"_blank\">Aetna, Cigna \u003c/a>and other insurers that pulled out of the exchanges: The startup uncertainty and potential patient population aren't worth the risk in year one.\u003c/p>\n\u003cp>But hospital executives also are fearful that agreeing to price concessions to play on the exchanges will hamper their efforts to bargain in the future.\u003c/p>\n\u003cp>\"[O]nce you've agreed to low rates for one company, how do you ever negotiate for more with that company or any other company?\" Michael Green, CEO of Concord Hospital, \u003ca href=\"http://www.concordmonitor.com/home/8450204-95/my-turn-heres-why-concord-hospital-opted-out\" target=\"_blank\">wrote in an\u003c/a> op-ed explaining why his hospital wouldn't participate in New Hampshire's exchange.\u003c/p>\n\u003cp>\"If the insurers decide to move small groups along with individual to the exchange, you could find that you've put your organization in financial peril,\" Green wrote.\u003c/p>\n\u003cp>\u003cstrong>Moving Forward\u003c/strong>\u003c/p>\n\u003cp>Every indication is that the narrow network model will become the standard.\u003c/p>\n\u003cp>\"I don't think there is anything about this trend that is limited to the exchange market,\" Sara Rosenbaum, a health policy professor at George Washington University, \u003ca href=\"http://www.modernhealthcare.com/article/20130817/MAGAZINE/308179921\" target=\"_blank\">told \u003cem>Modern Healthcare\u003c/em>\u003c/a>.\u003c/p>\n\u003cp>But in the meantime, the provider fights -- and still-troubled websites -- mean that there's considerable confusion over which doctors and hospitals will be included in which plans next year.\u003c/p>\n\u003cp>On Covered California's website, the FAQ encourages consumers to check directories available on the site to see if their doctor is listed. But one practical challenge: That provider directory \u003ca href=\"http://www.cmanet.org/news/detail/?article=covered-ca-still-working-out-kinks-in-provider\" target=\"_blank\">has been glitchy\u003c/a>. Another: Providers may end up negotiating \"right up to the Jan. 1, 2014 starting date,\" Phil Daigle of California Health Benefit Advisers \u003ca href=\"http://www.cahba.com/advice/2013/10/when_will_provider_networks_be.html\" target=\"_blank\">writes\u003c/a>.\u003c/p>\n\u003cp>Meanwhile, the dust-up over Covered California's hospitals is a sign of how quickly things can change -- and perhaps the lingering resistance to narrow networks, too.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>After this summer's fuss, officials eventually ensured that Cedars-Sinai is \u003ca href=\"http://cedars-sinai.edu/Patients/Insurance-Exchanges/Options-for-Purchasing-Individual-Coverage.aspx\" target=\"_blank\">now available\u003c/a> through a few plans on the state's exchange. And so is UCLA, which announced the news with a \u003ca href=\"http://www.uclahealth.org/body.cfm?id=2895\" target=\"_blank\">banner ad\u003c/a>: \"Covered California now offers a choice U know.\"\u003c/p>\n\n","blocks":[],"excerpt":"Search Covered California's website, and you'll find a list of 33 \"frequently asked questions.\"\r\n\r\nThe 33rd and final question -- below questions like \"Why should I buy health insurance?\" and \"I'm pregnant and do not have insurance. What health coverage is available for me?\" -- is this one: \"Will patients be able to keep their same doctor when they purchase health insurance through Covered California?\"\r\n\r\nThe question may be last on Covered California's list, but it's top-of-mind for many consumers. About one million Californians, and millions of other Americans, are losing their health plans through the individual market and turning to Obamacare's new insurance exchanges to shop for replacement coverage. And in many cases, it's still unclear if the family doctor will be coming with them","status":"publish","parent":0,"modified":1419973438,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":34,"wordCount":1014},"headData":{"title":"Why Narrow Networks May Not Be Such A Bad Idea | KQED","description":"Search Covered California's website, and you'll find a list of 33 "frequently asked questions."\r\n\r\nThe 33rd and final question -- below questions like "Why should I buy health insurance?" and "I'm pregnant and do not have insurance. What health coverage is available for me?" -- is this one: "Will patients be able to keep their same doctor when they purchase health insurance through Covered California?"\r\n\r\nThe question may be last on Covered California's list, but it's top-of-mind for many consumers. About one million Californians, and millions of other Americans, are losing their health plans through the individual market and turning to Obamacare's new insurance exchanges to shop for replacement coverage. And in many cases, it's still unclear if the family doctor will be coming with them","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"16450 http://blogs.kqed.org/stateofhealth/?p=16450","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/11/28/why-narrow-networks-may-not-be-such-a-bad-idea/","disqusTitle":"Why Narrow Networks May Not Be Such A Bad Idea","path":"/stateofhealth/16450/why-narrow-networks-may-not-be-such-a-bad-idea","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Dan Diamond\u003c/strong>, \u003ca href=\"http://www.californiahealthline.org/road-to-reform/2013/when-health-plans-drop-your-doctor-are-narrow-networks-a-bad-idea\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>Search Covered California's website, and you'll find a list of 33 \"frequently asked questions.\"\u003c/p>\n\u003cp>The 33rd and final question -- below questions like \"Why should I buy health insurance?\" and \"I'm pregnant and do not have insurance. What health coverage is available for me?\" -- is \u003ca href=\"https://www.coveredca.com/FAQs/#faq-27\" target=\"_blank\">this one\u003c/a>: \"Will patients be able to keep their same doctor when they purchase health insurance through Covered California?\"\u003c/p>\n\u003cp>The question may be last on Covered California's list, but it's top-of-mind for many consumers. About one million Californians, and \u003ca href=\"http://www.californiahealthline.org/road-to-reform/2013/how-many-people-are-losing-their-plans-under-obamacare-really\">millions of other Americans\u003c/a>, are losing their health plans through the individual market and turning to Obamacare's new insurance exchanges to shop for replacement coverage. And in many cases, it's still unclear if the family doctor will be coming with them.\u003c/p>\n\u003cp>\u003cstrong>The Mechanics Behind Narrow Networks\u003c!--more-->\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>This issue began to emerge back in May when Covered California announced its low premiums to some fanfare -- a \"home run\" for the state, officials \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/23/californias-health-insurance-exchange-sets-plans-premiums-no-apparent-rate-shock/\" target=\"_blank\">said at the time\u003c/a>.\u003c/p>\n\u003cp>But some critics seized on news that participating insurers had achieved those lower costs, in part, by \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/29/why-californias-obamacare-premiums-are-lower-than-expected/\" target=\"_blank\">relying on narrow networks\u003c/a> that excluded UCLA Medical Center and Cedars-Sinai Medical Center -- two of the state's most prominent, if expensive, hospitals.\u003c/p>\n\u003cp>Similar stories followed in other states, as exchanges released their rates and participating health care providers.\u003c/p>\n\u003cp>\"We knew it was going to be narrow,\" one Missouri insurance broker \u003ca href=\"http://www.kaiserhealthnews.org/stories/2013/september/26/narrow-insurance-network-missouri-exchange-marketplace.aspx\" target=\"_blank\">told \u003cem>Kaiser Health News\u003c/em>\u003c/a> after one local briefing. But the actual list of participating hospitals \"was kind of eye-opening.\"\u003c/p>\n\u003cp>The issue plays directly to one of the biggest fears sparked by the Affordable Care Act: The law will limit patient choice. But supporters say that's not the case.\u003c/p>\n\u003cp>\"Narrow networks may seem like a bad idea,\" David Dranove and Craig Garthwaite \u003ca href=\"http://dranove.wordpress.com/2013/10/22/broad-thinking-about-narrow-networks/\" target=\"_blank\">blogged last month\u003c/a>. The two Northwestern University professors acknowledged that excluding some providers from health plans offered through the exchanges runs the risk of disrupting care patterns.\u003c/p>\n\u003cp>But the model is \"not some cruel attempt to limit patient choice foisted upon us by the insurance industry,\" the professors added. \"Instead, these plans may provide our best opportunity for harnessing market forces to lower prices.\"\u003c/p>\n\u003cp>The simple equation: Insurers say that limiting the size of the network allows them to steer patients to high-quality facilities and doctors; participating providers, meanwhile, may agree to price cuts in exchange for new volumes.\u003c/p>\n\u003cp>And narrow networks aren't necessarily a new idea, Darius Tahir \u003ca href=\"http://www.nationaljournal.com/innovations-in-health/narrow-network-health-plans-expected-to-proliferate-under-obamacare-20131009\" target=\"_blank\">points out\u003c/a> at \u003cem>National Journal\u003c/em>. In some ways, it's the same concept behind payers' attempts in the 1980s and 1990s to limit their network size, which\u003ca href=\"http://www.managedcaremag.com/archives/0403/0403.narrow_networks.html\" target=\"_blank\"> met with criticism\u003c/a> and helped create \"Any Willing Provider\" laws.\u003c/p>\n\u003cp>Could narrow networks be better perceived -- and received -- with better phrasing? Industry consultant Vince Kuraitis thinks so.\u003c/p>\n\u003cp>\"The very term 'narrow network' creates a negative connotation and doesn't speak to potential benefits,\" \u003ca href=\"http://thehealthcareblog.com/blog/2013/10/22/in-defense-of-narrow-networks/comment-page-1/#comment-457059\" target=\"_blank\">Kuraitis comments\u003c/a> at The Health Care Blog. But choosing to describe \"the same networks as 'high-performance networks' or 'intelligent networks'... [t]he connotations here are much more positive.\"\u003c/p>\n\u003cp>\u003cstrong>Do Providers Want In? It's Complicated.\u003c/strong>\u003c/p>\n\u003cp>Some hospitals -- initially left out of exchange plans -- are fighting to be included.\u003c/p>\n\u003cul>\n\u003cli>Seattle Children's Hospital \u003ca href=\"http://seattletimes.com/html/localnews/2021968776_acachildrenssuitxml.html\" target=\"_blank\">sued the\u003c/a> state insurance commissioner, which helped \u003ca href=\"http://seattletimes.com/html/localnews/2022143835_acapremeraresponsexml.html\" target=\"_blank\">begin a battle\u003c/a>with a local insurer over whether the facility's rates are too high.\u003c/li>\n\u003cli>Eleven Kentucky hospitals have filed complaints; so far, the department has ordered Anthem to \u003ca href=\"http://www.courier-journal.com/article/20131124/BUSINESS/311240055/Kynect-policies-concern-eleven-Kentucky-hospitals?gcheck=1&nclick_check=1\" target=\"_blank\">accept applications\u003c/a> from three of those hospitals.\u003c/li>\n\u003c/ul>\n\u003cp>Yet many top facilities are \u003ca href=\"http://health.usnews.com/health-news/hospital-of-tomorrow/articles/2013/10/30/top-hospitals-opt-out-of-obamacare\" target=\"_blank\">choosing to opt out\u003c/a> of exchange plans.\u003c/p>\n\u003cp>And some doctors are sitting out, too, citing low reimbursement.\u003c/p>\n\u003cp>Presented with contracts that paid up to 30 percent less than traditional rates, \"we said, this doesn't make a whole lot of sense for us,\" Richard Thorp, president of the California Medical Association \u003ca href=\"http://online.wsj.com/news/articles/SB10001424052702304607104579212450545926912\" target=\"_blank\">told the \u003cem>Wall Street Journal\u003c/em>\u003c/a>.\u003c/p>\n\u003cp>Why? In part, prominent providers' doubts echo the concerns of \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/29/why-californias-obamacare-premiums-are-lower-than-expected/\" target=\"_blank\">Aetna, Cigna \u003c/a>and other insurers that pulled out of the exchanges: The startup uncertainty and potential patient population aren't worth the risk in year one.\u003c/p>\n\u003cp>But hospital executives also are fearful that agreeing to price concessions to play on the exchanges will hamper their efforts to bargain in the future.\u003c/p>\n\u003cp>\"[O]nce you've agreed to low rates for one company, how do you ever negotiate for more with that company or any other company?\" Michael Green, CEO of Concord Hospital, \u003ca href=\"http://www.concordmonitor.com/home/8450204-95/my-turn-heres-why-concord-hospital-opted-out\" target=\"_blank\">wrote in an\u003c/a> op-ed explaining why his hospital wouldn't participate in New Hampshire's exchange.\u003c/p>\n\u003cp>\"If the insurers decide to move small groups along with individual to the exchange, you could find that you've put your organization in financial peril,\" Green wrote.\u003c/p>\n\u003cp>\u003cstrong>Moving Forward\u003c/strong>\u003c/p>\n\u003cp>Every indication is that the narrow network model will become the standard.\u003c/p>\n\u003cp>\"I don't think there is anything about this trend that is limited to the exchange market,\" Sara Rosenbaum, a health policy professor at George Washington University, \u003ca href=\"http://www.modernhealthcare.com/article/20130817/MAGAZINE/308179921\" target=\"_blank\">told \u003cem>Modern Healthcare\u003c/em>\u003c/a>.\u003c/p>\n\u003cp>But in the meantime, the provider fights -- and still-troubled websites -- mean that there's considerable confusion over which doctors and hospitals will be included in which plans next year.\u003c/p>\n\u003cp>On Covered California's website, the FAQ encourages consumers to check directories available on the site to see if their doctor is listed. But one practical challenge: That provider directory \u003ca href=\"http://www.cmanet.org/news/detail/?article=covered-ca-still-working-out-kinks-in-provider\" target=\"_blank\">has been glitchy\u003c/a>. Another: Providers may end up negotiating \"right up to the Jan. 1, 2014 starting date,\" Phil Daigle of California Health Benefit Advisers \u003ca href=\"http://www.cahba.com/advice/2013/10/when_will_provider_networks_be.html\" target=\"_blank\">writes\u003c/a>.\u003c/p>\n\u003cp>Meanwhile, the dust-up over Covered California's hospitals is a sign of how quickly things can change -- and perhaps the lingering resistance to narrow networks, too.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>After this summer's fuss, officials eventually ensured that Cedars-Sinai is \u003ca href=\"http://cedars-sinai.edu/Patients/Insurance-Exchanges/Options-for-Purchasing-Individual-Coverage.aspx\" target=\"_blank\">now available\u003c/a> through a few plans on the state's exchange. And so is UCLA, which announced the news with a \u003ca href=\"http://www.uclahealth.org/body.cfm?id=2895\" target=\"_blank\">banner ad\u003c/a>: \"Covered California now offers a choice U know.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/16450/why-narrow-networks-may-not-be-such-a-bad-idea","authors":["8344"],"categories":["stateofhealth_15"],"tags":["stateofhealth_542"],"featImg":"stateofhealth_14038","label":"stateofhealth"},"stateofhealth_14505":{"type":"posts","id":"stateofhealth_14505","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"14505","score":null,"sort":[1377507627000]},"guestAuthors":[],"slug":"obamacare-to-force-millions-to-upgrade-insurance","title":"Obamacare to Force Millions to Upgrade Insurance","publishDate":1377507627,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_14506\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-14506\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/08/hall_photo2-640x480.jpg\" alt=\"Darren Hall will have to choose a new health insurance plan after Obamacare is fully implemented in January. His policy today doesn’t meet the standards outlined in the law. (Kelley Weiss/ CHCF Center for Health Reporting)\" width=\"640\" height=\"480\">\u003cfigcaption class=\"wp-caption-text\">Darren Hall will have to choose a new health insurance plan after Obamacare is fully implemented in January. His policy today doesn’t meet the standards outlined in the law. (Kelley Weiss/ CHCF Center for Health Reporting)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Kelley Weiss\u003c/strong>, \u003ca href=\"http://centerforhealthreporting.org/article/obamacare-force-millions-upgrade-insurance1152\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cp>Despite promises by President Obama that people can keep the insurance they have once Obamacare is in full effect in January, millions of people nationally will have to upgrade their policies.\u003c/p>\n\u003cp>That’s because these people have “bare bones” plans that don’t meet the Affordable Care Act benefit standards.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">Learn more about Obamacare in KQED's guide, specifically for Californians\u003c/a>\u003c/aside>\n\u003cp>Darren Hall is one of those people. He runs a pool service company in Sacramento. Since he’s self-employed he doesn’t get health insurance through his job, but buys it on his own.\u003c/p>\n\u003cp>He says it’s worked out pretty well until this spring when his monthly premium spiked from $250 a month to $300 dollars overnight.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>So he says he looked for a better deal and found another health insurance policy for half as much.\u003c/p>\n\u003cp>“As a small business you have your ups and downs and so every dollar does count,” Hall says. “Another $150, that’s half a truck payment right there.\"\u003c!--more-->\u003c/p>\n\u003cp>Hall got this new policy in April and it’s another high-deductible health plan. He pays for the first $1,500 of medical care out-of-pocket to meet his deductible. He doesn’t get coverage for certain benefits but that leaves him with a lower monthly premium.\u003c/p>\n\u003cp>Since he’s hardly needed any medical care in the last 14 years, Hall says it’s been just fine.\u003c/p>\n\u003cp>“The amount of times I’ve been to see a doctor I can probably count on one hand,” he says.\u003c/p>\n\u003cp>But Hall says now there’s a problem. He’s going to have to choose another insurance policy soon because his doesn’t meet the standards under the Affordable Care Act.\u003c/p>\n\u003cp>“Folks are going to have to buy more comprehensive policies, generally, in 2014,” says Micah Weinberg, a senior policy consultant with the Bay Area Council.\u003c/p>\n\u003cp>He says a small portion of people might be able to \u003ca href=\"https://www.healthcare.gov/what-if-i-have-a-grandfathered-health-plan/\" target=\"_blank\">keep their policy if they have a grandfathered plan\u003c/a>, meaning they had it on March 23, 2010. But he says Hall and millions of other people have individual health plans today that won’t cut it.\u003c/p>\n\u003cp>“Most of the policies sold in the individual market are much skinnier than the policies provided by employers,” he says.\u003c/p>\n\u003cp>Weinberg says the Affordable Care Act \u003ca href=\"https://www.healthcare.gov/what-does-marketplace-health-insurance-cover/\">requires all insurance policies to cover 10 benefits\u003c/a>, including things like hospitalizations, maternity care or prescription drugs. The idea, he says, is to protect people with a high deductible plan, like Darren Hall, from financial calamity.\u003c/p>\n\u003cp>“A lot of what the Affordable Care Act does is prevent moments of terror, panic, bankruptcy that we didn’t anticipate were even going to happen,” Weinberg says.\u003c/p>\n\u003cp>Obamacare will do this, he says, by making insurers pick up at least 60 percent of medical costs. And it caps out-of-pocket spending for individuals to around $6,400 per year.\u003c/p>\n\u003cp>People can also get help if they buy a plan on the newly formed health care marketplaces and qualify for a subsidy. But this won’t help everyone. Take, for example, the two million people in California who buy insurance on their own today. Only about a third will qualify for tax subsidies. Darren Hall makes too much money to qualify.\u003c/p>\n\u003cp>Sarah Aquino, of Integrated Benefits and Insurance Services Inc., says those who don’t qualify for a subsidy will likely see their premiums increase.\u003c/p>\n\u003cp>\u003ca href=\"http://kff.org/interactive/subsidy-calculator/\">To qualify for a tax subsidy\u003c/a> an individual has to make less than $46,000 a year, or 400 percent of the Federal Poverty Level.\u003c/p>\n\u003cp>But Aquino says most of her clients make more than that. Regardless, almost everyone has to have insurance or pay a fee come January. And Aquino says if that insurance is going to be more expensive, people will have a choice to make.\u003c/p>\n\u003cp>“The penalty for the individual mandate is $95 or one percent of your income,” she says. “So the question is will people who are healthy and don’t qualify for a subsidy come into the system?”\u003c/p>\n\u003cp>Aquino says the most important thing is for people to learn what their options are. And, she adds, it’s not a bad idea to start now.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced in collaboration with the \u003ca href=\"http://centerforhealthreporting.org/\">\u003cstrong>California HealthCare Foundation Center for Health Reporting\u003c/strong>\u003c/a>\u003cstrong>,\u003c/strong> a nonprofit news organization that focuses on California health issues. Based at the \u003ca href=\"http://annenberg.usc.edu/\">\u003cstrong>USC Annenberg School for Communication and Journalism\u003c/strong>\u003c/a>, the center is funded by the nonpartisan \u003cstrong>\u003ca href=\"http://www.chcf.org/\">California HealthCare Foundation.\u003c/a> \u003c/strong>The story first appeared on \u003ca href=\"http://www.npr.org/2013/08/23/214723180/obamacare-to-force-millions-to-upgrade-insurance\" target=\"_blank\">NPR\u003c/a>.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Despite promises by President Obama that people can keep the insurance they have once Obamacare is in full effect in January, millions will have to upgrade their policies.\r\nThat’s because these people have “bare bones” plans that don’t meet the Affordable Care Act benefit standards.","status":"publish","parent":0,"modified":1377554161,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":26,"wordCount":838},"headData":{"title":"Obamacare to Force Millions to Upgrade Insurance | KQED","description":"Despite promises by President Obama that people can keep the insurance they have once Obamacare is in full effect in January, millions will have to upgrade their policies.\r\nThat’s because these people have “bare bones” plans that don’t meet the Affordable Care Act benefit standards.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"14505 http://blogs.kqed.org/stateofhealth/?p=14505","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/08/26/obamacare-to-force-millions-to-upgrade-insurance/","disqusTitle":"Obamacare to Force Millions to Upgrade Insurance","path":"/stateofhealth/14505/obamacare-to-force-millions-to-upgrade-insurance","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_14506\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-14506\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/08/hall_photo2-640x480.jpg\" alt=\"Darren Hall will have to choose a new health insurance plan after Obamacare is fully implemented in January. His policy today doesn’t meet the standards outlined in the law. (Kelley Weiss/ CHCF Center for Health Reporting)\" width=\"640\" height=\"480\">\u003cfigcaption class=\"wp-caption-text\">Darren Hall will have to choose a new health insurance plan after Obamacare is fully implemented in January. His policy today doesn’t meet the standards outlined in the law. (Kelley Weiss/ CHCF Center for Health Reporting)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Kelley Weiss\u003c/strong>, \u003ca href=\"http://centerforhealthreporting.org/article/obamacare-force-millions-upgrade-insurance1152\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cp>Despite promises by President Obama that people can keep the insurance they have once Obamacare is in full effect in January, millions of people nationally will have to upgrade their policies.\u003c/p>\n\u003cp>That’s because these people have “bare bones” plans that don’t meet the Affordable Care Act benefit standards.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">Learn more about Obamacare in KQED's guide, specifically for Californians\u003c/a>\u003c/aside>\n\u003cp>Darren Hall is one of those people. He runs a pool service company in Sacramento. Since he’s self-employed he doesn’t get health insurance through his job, but buys it on his own.\u003c/p>\n\u003cp>He says it’s worked out pretty well until this spring when his monthly premium spiked from $250 a month to $300 dollars overnight.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>So he says he looked for a better deal and found another health insurance policy for half as much.\u003c/p>\n\u003cp>“As a small business you have your ups and downs and so every dollar does count,” Hall says. “Another $150, that’s half a truck payment right there.\"\u003c!--more-->\u003c/p>\n\u003cp>Hall got this new policy in April and it’s another high-deductible health plan. He pays for the first $1,500 of medical care out-of-pocket to meet his deductible. He doesn’t get coverage for certain benefits but that leaves him with a lower monthly premium.\u003c/p>\n\u003cp>Since he’s hardly needed any medical care in the last 14 years, Hall says it’s been just fine.\u003c/p>\n\u003cp>“The amount of times I’ve been to see a doctor I can probably count on one hand,” he says.\u003c/p>\n\u003cp>But Hall says now there’s a problem. He’s going to have to choose another insurance policy soon because his doesn’t meet the standards under the Affordable Care Act.\u003c/p>\n\u003cp>“Folks are going to have to buy more comprehensive policies, generally, in 2014,” says Micah Weinberg, a senior policy consultant with the Bay Area Council.\u003c/p>\n\u003cp>He says a small portion of people might be able to \u003ca href=\"https://www.healthcare.gov/what-if-i-have-a-grandfathered-health-plan/\" target=\"_blank\">keep their policy if they have a grandfathered plan\u003c/a>, meaning they had it on March 23, 2010. But he says Hall and millions of other people have individual health plans today that won’t cut it.\u003c/p>\n\u003cp>“Most of the policies sold in the individual market are much skinnier than the policies provided by employers,” he says.\u003c/p>\n\u003cp>Weinberg says the Affordable Care Act \u003ca href=\"https://www.healthcare.gov/what-does-marketplace-health-insurance-cover/\">requires all insurance policies to cover 10 benefits\u003c/a>, including things like hospitalizations, maternity care or prescription drugs. The idea, he says, is to protect people with a high deductible plan, like Darren Hall, from financial calamity.\u003c/p>\n\u003cp>“A lot of what the Affordable Care Act does is prevent moments of terror, panic, bankruptcy that we didn’t anticipate were even going to happen,” Weinberg says.\u003c/p>\n\u003cp>Obamacare will do this, he says, by making insurers pick up at least 60 percent of medical costs. And it caps out-of-pocket spending for individuals to around $6,400 per year.\u003c/p>\n\u003cp>People can also get help if they buy a plan on the newly formed health care marketplaces and qualify for a subsidy. But this won’t help everyone. Take, for example, the two million people in California who buy insurance on their own today. Only about a third will qualify for tax subsidies. Darren Hall makes too much money to qualify.\u003c/p>\n\u003cp>Sarah Aquino, of Integrated Benefits and Insurance Services Inc., says those who don’t qualify for a subsidy will likely see their premiums increase.\u003c/p>\n\u003cp>\u003ca href=\"http://kff.org/interactive/subsidy-calculator/\">To qualify for a tax subsidy\u003c/a> an individual has to make less than $46,000 a year, or 400 percent of the Federal Poverty Level.\u003c/p>\n\u003cp>But Aquino says most of her clients make more than that. Regardless, almost everyone has to have insurance or pay a fee come January. And Aquino says if that insurance is going to be more expensive, people will have a choice to make.\u003c/p>\n\u003cp>“The penalty for the individual mandate is $95 or one percent of your income,” she says. “So the question is will people who are healthy and don’t qualify for a subsidy come into the system?”\u003c/p>\n\u003cp>Aquino says the most important thing is for people to learn what their options are. And, she adds, it’s not a bad idea to start now.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced in collaboration with the \u003ca href=\"http://centerforhealthreporting.org/\">\u003cstrong>California HealthCare Foundation Center for Health Reporting\u003c/strong>\u003c/a>\u003cstrong>,\u003c/strong> a nonprofit news organization that focuses on California health issues. Based at the \u003ca href=\"http://annenberg.usc.edu/\">\u003cstrong>USC Annenberg School for Communication and Journalism\u003c/strong>\u003c/a>, the center is funded by the nonpartisan \u003cstrong>\u003ca href=\"http://www.chcf.org/\">California HealthCare Foundation.\u003c/a> \u003c/strong>The story first appeared on \u003ca href=\"http://www.npr.org/2013/08/23/214723180/obamacare-to-force-millions-to-upgrade-insurance\" target=\"_blank\">NPR\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/14505/obamacare-to-force-millions-to-upgrade-insurance","authors":["8344"],"categories":["stateofhealth_15"],"tags":["stateofhealth_542","stateofhealth_461"],"featImg":"stateofhealth_14506","label":"stateofhealth"},"stateofhealth_13253":{"type":"posts","id":"stateofhealth_13253","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"13253","score":null,"sort":[1371230930000]},"guestAuthors":[],"slug":"california-insurance-chief-bar-anthem-from-small-business-marketplace","title":"California Insurance Chief: Bar Anthem from Small Business Marketplace","publishDate":1371230930,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>\u003cstrong>By Mina Kim, KQED\u003c/strong>\u003c/p>\n\u003cp>California's insurance commissioner Dave Jones says Anthem Blue Cross shouldn't be allowed to sell small business health plans on Covered California, the state's new health insurance marketplace being set up under the requirements of the federal health law. Jones says Anthem, the state's largest insurer, has been engaging in a \"pattern\" of \"excessive\" rate hikes.\u003c/p>\n\u003cp>\"It simply cannot be the case that a health insurer can unreasonably gouge its small business customers and not face any consequences whatsoever,\" Jones said.\u003c/p>\n\u003cp>Under state law, Jones can review health plan rate hikes and declare them unreasonable, but he lacks authority to block them.\u003c!--more-->\u003c/p>\n\u003cp>Covered California's Peter Lee says he's taking the Commissioner's request into consideration.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"But the first thing we want to make sure is that we have a good mix of plans that have affordable prices and good networks of doctors and hospitals that will serve consumers,\" Lee said.\u003c/p>\n\u003cp>Lee already approved Anthem Blue Cross for the state's individual\u003cem> \u003c/em>health plan market. Anthem spokesman Darrel Ng says the company's recent rate increases are all in line with state projections of rising health care costs.\u003c/p>\n\u003cp>\"We look forward to working with Covered California to bring these competitive rates to the small group exchange,\" Ng said.\u003c/p>\n\u003cp>Excluding such a large insurer from the small business exchange could reduce competition. Last month, Covered California \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/23/californias-health-insurance-exchange-sets-plans-premiums-no-apparent-rate-shock/\" target=\"_blank\">released preliminary plans and premiums\u003c/a> for the individual marketplace. The agency is expected to release small business plans and premiums sometime this summer.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n","blocks":[],"excerpt":"California's insurance commissioner Dave Jones says Anthem Blue Cross shouldn't be allowed to sell small business health plans on Covered California, the state's new health insurance marketplace being set up under the requirements of the federal health law. Jones says Anthem, the state's largest insurer, has been engaging in a \"pattern\" of \"excessive\" rate hikes.\r\n\r\n\"It simply cannot be the case that a health insurer can unreasonably gouge its small business customers and not face any consequences whatsoever,\" Jones said.","status":"publish","parent":0,"modified":1371230930,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":11,"wordCount":262},"headData":{"title":"California Insurance Chief: Bar Anthem from Small Business Marketplace | KQED","description":"California's insurance commissioner Dave Jones says Anthem Blue Cross shouldn't be allowed to sell small business health plans on Covered California, the state's new health insurance marketplace being set up under the requirements of the federal health law. Jones says Anthem, the state's largest insurer, has been engaging in a "pattern" of "excessive" rate hikes.\r\n\r\n"It simply cannot be the case that a health insurer can unreasonably gouge its small business customers and not face any consequences whatsoever," Jones said.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"13253 http://blogs.kqed.org/stateofhealth/?p=13253","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/06/14/california-insurance-chief-bar-anthem-from-small-business-marketplace/","disqusTitle":"California Insurance Chief: Bar Anthem from Small Business Marketplace","path":"/stateofhealth/13253/california-insurance-chief-bar-anthem-from-small-business-marketplace","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Mina Kim, KQED\u003c/strong>\u003c/p>\n\u003cp>California's insurance commissioner Dave Jones says Anthem Blue Cross shouldn't be allowed to sell small business health plans on Covered California, the state's new health insurance marketplace being set up under the requirements of the federal health law. Jones says Anthem, the state's largest insurer, has been engaging in a \"pattern\" of \"excessive\" rate hikes.\u003c/p>\n\u003cp>\"It simply cannot be the case that a health insurer can unreasonably gouge its small business customers and not face any consequences whatsoever,\" Jones said.\u003c/p>\n\u003cp>Under state law, Jones can review health plan rate hikes and declare them unreasonable, but he lacks authority to block them.\u003c!--more-->\u003c/p>\n\u003cp>Covered California's Peter Lee says he's taking the Commissioner's request into consideration.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"But the first thing we want to make sure is that we have a good mix of plans that have affordable prices and good networks of doctors and hospitals that will serve consumers,\" Lee said.\u003c/p>\n\u003cp>Lee already approved Anthem Blue Cross for the state's individual\u003cem> \u003c/em>health plan market. Anthem spokesman Darrel Ng says the company's recent rate increases are all in line with state projections of rising health care costs.\u003c/p>\n\u003cp>\"We look forward to working with Covered California to bring these competitive rates to the small group exchange,\" Ng said.\u003c/p>\n\u003cp>Excluding such a large insurer from the small business exchange could reduce competition. Last month, Covered California \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/23/californias-health-insurance-exchange-sets-plans-premiums-no-apparent-rate-shock/\" target=\"_blank\">released preliminary plans and premiums\u003c/a> for the individual marketplace. The agency is expected to release small business plans and premiums sometime this summer.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/13253/california-insurance-chief-bar-anthem-from-small-business-marketplace","authors":["8344"],"categories":["stateofhealth_166","stateofhealth_15","stateofhealth_13"],"tags":["stateofhealth_542"],"label":"stateofhealth"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? 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