Skip to main content

Narrow Provider Networks For Exchange Health Plans?

An article in today's Wall Street Journal reinforces something we brokers have known for quite some time--health exchange plans will have limited provider networks for access to healthcare.

These networks, known as limited or narrow networks (a newer term is ACO - accountable care org) will have a much smaller number of participating providers and will be working with lower negotiated rate schedules than traditional networks such as Blue Cross' Prudent Buyer Network.

For those who purchase health coverage inside of the exchange, the availability of healthcare providers will be markedly less than plans sold on the open market.  This may mean that Blue Cross or Blue Shield PPO health plans may not offer BlueCard national PPO access on plans sold through the exchange leaving that benefit to normal network plans sold outside of the exchange.

Once the California health plans are developed and released for the exchange and non-exchange markets, we will have a clearer idea about the networks available in both markets.



  1. the main question should be how will this impact the industry?


Post a Comment

Popular posts from this blog

Right Angle: ObamaCare At Death's Door

The Right Angle team (Bill Whittle, Scott Ott and Steven Green) on the Bill Whittle YouTube Channel give their take of the current state of the Affordable Care Act.  

Some very interesting information in this video.  

Oren Cass Manhattan Institute Article referenced in the video:

No, Obamacare Has Not Saved American Lives


Mo Brooks Introduces One Line Bill to Repeal Obamacare

Mo Brooks (R-AL) has entered a one sentence bill for repeal of the ACA (ObamaCare). Seen as more of a symbolic gesture (the bill did not go to vote in the House), he gets right to the point in a succinct fashion...

“Effective as of Dec. 31, 2017, the Patient Protection and Affordable Care Act is repealed, and the provisions of law amended or repealed by such Act are restored or revived as if such Act had not been enacted.”
Full article from The Libertarian Republic


Kaiser Foundation Interactive Subsidy Map (TrumpCare vs. ObamaCare)

An interactive subsidy map provided by Kaiser Foundation allows you to see the impact of tax credit subsidy (2020) versus income-based subsidy (current).  Sorted by county in all 50 states.  Those above 400% federal poverty level would do much better, those below, depends on county and income.  Most below 200% would do much worse.  

Subsidies under ACA are based primarily on income.  Tax Credits would be based primarily on age.