Kevin Drum raises a good question this weekend on different challenges (actual and political) that Obamacare faces in the next six to nine months:
network shock might actually be a bigger issue. It’s one thing to get a rate increase. That’s bad, but it’s often tolerable, and everyone in the individual market is pretty used to big annual premium increases anyway. But a lot of plans on the exchange restrict doctor networks fairly severely, and this could be a big problem for people who are loyal to their current physicians.
In most markets where there are multiple insurers offering plans, the insurers aren’t offering just one plan per metal band.
Mayhew Insurance is not just offering Mayhew Catastrophic, Bronze, Silver, Gold. Mayhew Insurance is offering Mayhew Silver Basic, Mayhew Silver Premium, Mayhew Silver Enhanced Premium, Mayhew Silver Superb. The same is with the local Blue Cross affiliate as well as the major national players.
Each of those plans are Silver plans (70% actuarial value). Mayhew Silver Basic is the cheapest, and Mayhew Silver Superby is the most expensive. There are probably a few significant differences that drive the prices. The first is the higher cost plans probably have a more expansive and expensive prescription drug formulary. The second is the network is wider.
In most markets where there is a decent number of companies offering plans, Dr. X will be available in at least a couple of plans on the market at a given metal level. It is just unlikely that Dr. X will be available in all of the low price (for the metal band) plans.