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Monday, September 30, 2013


The first health insurance plans in the ACA marketplace go on sale tomorrow. The government says most Texans will have an average of 54 plans to choose from at low prices. But there’s a cost to pay for that. News reports seem to confirm some of our biggest concerns about the plans: The networks will be very narrow, and payments will likely be on the low side. The New York Times, for example, reported growing concerns over narrow networks that are leaving out many physicians and hospitals. “Decades of experience with Medicaid, the program for low-income people, show that having an insurance card does not guarantee access to specialists or other providers,” Times reporter Robert Pear wrote, echoing a statement we’ve been making for years. And a MedPageToday story carries this headline: “Expect Low Pay for Docs in Exchange Plans.” Here in Texas, we’ve heard anecdotally from some physicians that the offers are lower, but we can't quantify what that means. Lower for that practice? Lower for the market?

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