Many patients insured through the ACA have been finding it difficult to find specialists and hospitals that accept their insurance. In particular, patients with lower-cost plans are running into problems with coverage, finding that many hospitals and specialists are not in their plan’s network. Physicians say they cannot refer patients with narrow plans to specialists they think are the best because of the limited options. This comes as a surprise to many who believed the Affordable Care Act would improve the system and lessen these barriers. In some cases, even public health systems are not taking the new marketplace plans. Experts say that narrow networks are “a powerful tool for insurance companies seeking to control costs-especially since they can no longer control costs by excluding sick people or adjusting premiums by gender or age.” By restricting the choices in a plan, insurers can promise doctors and hospitals more customers and in turn, the insurers get a break on what they pay those doctors and hospitals.
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