Some experts have said that the experience of shopping for health insurance on the new online marketplaces that will open for enrollment this October under the Affordable Care Act will be like booking a vacation on Travelocity. But for those who make the wrong insurance purchase, the stakes could be much higher than an inconvenient layover or a hotel room without a view, and consumers who base their decision on price alone may be in for some unwelcome surprises.
Chief among them: Some patients may have a difficult time seeing their current doctors under the new plans.
Consumer advocates have anticipated that the ACA will be a big help to boomers who are looking to retire early or set out their own shingle, since they’ll no longer be tethered to their job for the health benefits. Between 500,000 and 900,000 Americans could choose to stop working or retire early, based on their new options for insurance outside their job, according to a new study by researchers at the Columbia University Mailman School of Public Health, Northwestern University Kellogg School of Management, and the University of Chicago Booth School of Business. Another report, released this spring by the Robert Wood Johnson Foundation, estimated that the number of self-employed Americans will grow by 1.5 million in 2014 because access to high-quality, subsidized health insurance coverage will no longer be exclusively tied to employment.
Yet prospective early retirees or freelancers shouldn’t assume that plans on the state-level marketplaces will offer them the same doctor choices that their employer-provided insurance does. “You really need to pay attention to the network,” said Sara Rosenbaum, law professor at the George Washington University who has closely tracked the health-care law’s rollout. Economic forces behind the new insurance exchanges are putting pressure on insurers to keep prices low, and one of their main ways to accomplish that, given the law’s requirements, is to offer fewer doctor options. And while healthy 20-somethings might be happy to accept limited choice in exchange for lower premiums, that trade-off might not look as attractive to boomers who’d rather not, say, find another cardiologist.
Date: July 31, 2013