Short Takes On News & Events

Poll: For Right Price, Consumers Will Accept Limited Choice Of Doctors, Hospitals

By Jordan Rau

February 26th, 2014, 5:55 AM

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.

6 Responses to “Poll: For Right Price, Consumers Will Accept Limited Choice Of Doctors, Hospitals”

  1. Bruce Rector says:

    The new plans need narrower networks to keep down premiums, it is good to hear that some people accept that. I was talking to a medical director of a ACA coop, which is trying to keep its premiums down. He says that they are making big efforts on formularies – trying to convince customers to accept generics in order to keep premiums down. I have seen only limited information on formularies. Is there much evidence that this is happening and are customers open to accepting this trade off?

  2. John Newton says:

    I accepted a Blue Advantage plan with its limited choice.
    The trouble is there may be NO doctor who is in-network, even in major metroploitian areas.
    The insurance provider list are highly inaccurate.
    Already two PCP’s dropped out of the Advantage plan. Then members have no insurance until the beginning of the next month due to spiteful insurance rules.
    There is no in-network place for my wife to get a mammogram, a required service under the ACA.
    If insured write these findings in the insurers member email, they eventually state they are unable to help or don’t reply at all.
    Many customer service representatives know these truths but cannot speak up or else they would be fired.

    The most glaring situation (for anyone to see in 10 seconds) is Hospital Based Physicians, which 98%+ are out-of-network.

    There is NO ONE you can see at IN-NETWORK hospitals. There is NO INSURANCE for out-of-network providers. ** No balance billing ** .
    Get it? So please quite writing these superficial articles and acting like an impartial authority.
    I wish Kaiser would report on these all important FACTS.

  3. Killroy71 says:

    Younger and poorer people are more likely to be ok with narrow networks — well, that’s the target market for exchanges and Medicaid expansion, so insurers are targeting the product to the audience.

    You want a cadillac plan, you pay a cadillac price. But if a ford focus will get you where you need to go, you pay less. That’s the marketplace. What will really help is pairing narrow networks with more coordinated care. That has potential to bring underlying costs down, not just premium.

    As to whether ACA will raise costs – there’s no question. You can’t pass a law intended to raise billions of dollars through premium and medical device taxes and not expect those costs to be passed through to consumers. ACA had to raise money somehow to pay for expanding access. They chose to do this on the backs of already-vilified health insurers instead of outright taxation.

  4. George Fulmore says:

    Note that Kaiser Permanente does NOT restrict access to doctors in its network. In Northern CA, Kaiser has about 6,000 doctors. That can be seen as an advantage to a low-cost Kaiser plan, if you can somehow figure out how to manage a deductibles plan.

  5. Bryan says:

    Health insurers are being vilified for good reason. They have been bilking consumers for decades. They have been cherry-picking healthy subscribers and refusing those with health issues for decades. NEWS FLASH FOR BOZOS: Nobody trusts private health insurers. They lost their credibility long ago and they will never recover. The sooner we eliminate private health insurers from America’s healthcare system, the better. Obamacare takes the first step toward universal single-payer government run healthcare. The rest of the industrialized world seems to operate their healthcare systems very well without insurance companies in control and constantly interfering with the doctor/patient relationship. It’s time to dump the private insurers once and for all!

  6. Rando says:

    While Republicans continue to call for repeal and not replace, enrollment numbers seem to be catching up to their projected targets. The more Republicans talk about repeal, the more uninsured people we are seeing flock to sign up. Republicans are dopes. They are anti-everything! The party of negativity! Frustrated old white racist gun toting impotent males.