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More Unexpected ACA Fallout: States Starting to Take Action Against Limited-Provider Networks

Officials in at least a half dozen states are pushing back against health plans in the new insurance markets that limit choice of doctors and hospitals in a bid to control medical costs.

The plans don’t start offering coverage until January but they’re facing regulatory action, possible legislation, and in at least one case involving a high-profile children’s hospital, litigation.

The pushback against “narrow” provider networks recalls the backlash against managed care and health maintenance organizations  in the 1990s. Protests from consumers and hospitals eroded those attempts to restrain expenses by narrowing provider networks.

Now criticism of limited networks has risen as consumers realize that, despite President Barack Obama’s pledge that they could keep their doctors, their Affordable Care Act insurance may not include the physicians or hospitals they’ve been seeing.

The critique feeds into the politically damaging outcry over the millions of people whose health plans were cancelled. It’s unclear whether the limited choice of doctors and other providers will be as much of a concern to uninsured people who will be gaining subsidized coverage through the state-based marketplaces. . .

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