Obamacare Narrows Provider Networks and Drug Formularies
Rules and regulations Obamacare imposes on insurance plans sold in the individual market make means narrower networks and drug formularies. The participating insurance companies are curtailing these coverage aspects to keep premiums lower.
Narrow Provider Networks. An analysis by the consulting firm McKinsey & Co. found that 48 percent of all exchange networks nationwide are narrowed. This significantly reduces provider choices for those who purchase insurance through the Obamacare exchanges.
Limited Drug Formularies: In addition to limited access to providers, a lot of Obamacare’s plans offer more limited drug coverage. This means that those insured through the exchange may find that they do not have the ability to fill prescriptions without significant cost sharing that would burden them with thousands of dollars of out of pocket expenses, even after they had exhausted their deductible.
It’s not surprising that plans are more focused on meeting government targets and dictates than competing based on consumer demands that would result in better quality and lower cost. Thus, as The Heritage Foundation has noted, “[A] precondition to any well-functioning, consumer-centered market is that lawmakers avoid unduly restricting either the options available to consumers or the scope for supplier innovation.”
Tony Burlo, a partner in the Health Insurance Exchange Alternative, when asked about these issues, stated, “The Health Insurance Exchange Alternative insurance policies provide wide network coverage so that insureds my choose their healthcare provider and access to formularies with no hidden deductible costs”.