A Modern Healthcare article has an extensive piece on initial Exchange consumer reaction to narrow networks. Besides wanting better web directories, people are relatively happy with them. However there is a throw-away line at the end concerning the proliferatin of narrow networks on the commercial/employer sponsored insurance side of the business that I think is wrong:
Jon Gabel, a senior fellow who studies insurance markets at the National Opinion Research Center at the University of Chicago, told Modern Healthcare in March that if narrow networks “spill over into employer-based health insurance, I think we’ll see much more politically potent backlash.”
As I noted last July, most of the popular plans sold to groups by Mayhew Insurance are narrow network or tiered network plans.
Note that the three commercial networks which are the top sellers by membership are narrow to very narrow networks and they were all fundamentally built when President Obama was either a state senator or a junior Senator in D.C.
I think he is wrong for two reasons. First, the big trend for large groups and Fortune 1000 companies over the past several years have been to keep employee contributions reasonably stable while jacking up the deductible. Companies that were offering low Platinum or good Gold style plans in 2012 are now offering weak Silvers as the base option. A lower deductible but narrower network option at the same employee contribution per paycheck is a trade-off a lot of people are willing to make on an individual basis (that is what I choose for my family).
So on the first front, narrow networks have been around for a while and they have been common for large groups for at least a decade in my market. Secondly, as long as the networks are well disclosed, directories frequently updated and the narrow network is not the default or only option, but instead are a part of a set of choices, I don’t think there will be a potent backlash.