“This doesn’t surprise me,” said Gail Wilensky, Medicare advisor for the second Bush Administration and senior fellow for Project HOPE. “There has been an incredible amount of focus on the premium cost and subsidy, and precious little focus on what you get for your money.”
Regulations driven by the Obama White House have indeed made insurance more affordable – if, like Health and Human Services Secretary Kathleen Sebelius, you’re looking only at price. But responding to Obamacare caps on premiums, many insurers will, in turn, simply offer top-tier doctors and hospitals far less cash for services rendered.
Not to mention that insurance is in many cases NOT more affordable.
Chances are the individual plan you purchased outside Obamacare would allow you to go to these facilities. For example, fourth-ranked Cleveland Clinic accepts dozens of insurance plans if you buy one on your own. But go through Obamacare and you have just one choice: Medical Mutual of Ohio.
And that’s not because their exchanges don’t offer options. Both Ohio and California have a dozen insurance companies on their exchanges, yet two of the states’ premier hospitals – Cleveland Clinic and Cedars-Sinai Medical Center – have only one company in their respective networks.
A good local example here is Colorado is Children’s Hospital is not in he Anthem BCBS network.
When looking at ACA/Obamacare plans, you must be concerned about the network. Also, if you are near a state border, travel a lot or have two residences, keep in mind that with a vast majority of the plans you are out of network for non-emergency care performed out of state.