People buying health insurance through the health law’s new online marketplaces are more willing than the public at large to accept a limited roster of doctors and hospitals in return for lower premiums, a poll released Wednesday finds. But that enthusiasm nosedives if they are told their regular doctor isn’t included in the plan.
As a way to keep costs down and be competitive, insurers across the country have pieced together limited networks of doctors, hospitals and other medical providers. Consumers wanting broader choices of providers are often given the option of buying plans with higher premiums. The narrow networks have encountered resistance from doctors, patient groups and some insurance regulators, who fear consumers will not grasp their limited options until they seek medical care. Roughly 6 million people this year are expected to buy their own insurance through the health care exchanges that started operation in January.
Most people with private insurance still get their coverage through their employer. Among members of that group, limited networks are unpopular, according to the poll from The Kaiser Family Foundation. (KHN is an editorially independent program of the foundation.) Fifty-five percent would rather buy a plan that costs more but allows them to see a wider range of doctors and hospitals, while only 34 percent prefer a less expensive plan with limited providers.
However, those views are reversed among people who either lack insurance or are buying their own coverage. Only 35 percent would pay more for a greater array of options, while 54 percent said they would rather save money and accept the narrower choices.
That willingness wanes if they are told they cannot visit their usual doctor or hospital. In that case, the share of people buying their own insurance who are willing to go into the narrower network drops from 54 percent to 35 percent.
Conversely, more people are willing to embrace a narrower network if told they could save up to 25 percent on their health care costs. After mulling those savings, those who favored the broader network shrunk from 35 percent to 22 percent among the uninsured and people buying coverage on their own.
Among the public overall, younger people and poorer people are more likely to favor the smaller networks than older and wealthier people, the poll found.
The pollsters found that the health law’s unpopularity among the general public continues, with 47 percent holding a critical view and 35 percent favoring it. The unpopularity of the law among the uninsured is climbing, although the pollsters noted that may have more to do with the nature of those who remain uninsured, five months after insurers started enrolling people. “Some changes in opinion may be attributable to changes in who remains uninsured, rather than a shift in opinion among individuals,” the pollsters wrote.
The poll found that about half the public believes the health law has contributed to rising health care costs. The view is much more prevalent among Republicans than Democrats.
Among the general public, high hospital charges are the most common explanation given for rising costs, with 73 percent blaming hospitals. The next most frequently cited reasons for high health costs were an excess of fraud and waste and a general view that all kinds of things are getting more expensive. More than half the public also blames drug and insurance company profits and advances in medical equipment, treatments and medicines. And more than four in 10 people believe doctors charge too much, people are getting more tests and services than they really need and high prices reflect the cost of defending against medical malpractice lawsuits, according to the poll.
The poll was conducted from Feb. 11 through 17 among 1,501 adults via land lines and cell phones. The margin of error for the full sample was +/- 3 percentage points and +/- 7 percent for the uninsured and people buying coverage on their own.