New Study Finds Some Bad News Related to Doctor Choices Under Obamacare Exchanges

The number of doctors available on average Obamacare exchanges is more than one-third fewer than it would be on an average private health insurance network, a new study found. For cancer specialists, the decline is even more pronounced.

The study by Avalere Health, a health care consulting firm, found “health insurance exchanges created by the Affordable Care Act (ACA) include 34 percent fewer providers than the average commercial plan offered outside the exchange.”

(Andrew Harrer/Bloomberg via Getty Images)

For cancer treatment, the number declines further, while the number of choices for a heart specialists is about a quarter fewer under the Obamacare marketplace than under private insurance.

“Specifically, the analysis finds that exchange plan networks include 42 percent fewer oncology and cardiology specialists; 32 percent fewer mental health and primary care providers; and 24 percent fewer hospitals. Importantly, care provided by out-of-network providers does not count toward the out-of-pocket limits put in place by the ACA,” the study says.

The exchanges had been in the forefront of the news when the Supreme Court voted 6-3 last month in deciding that the ACA law intended for the federal exchange, healthcare.gov, to be available in states where a state government didn't establish an Obamacare marketplace.

The study was done evaluating the top five states affected by the health exchanges: Florida, California, Texas, Georgia, and North Carolina. It compared the average number of providers in the ACA exchanges with the number of doctors in commercial networks in those states.

“Plans continue to test new benefit designs in the exchange market,” Avaler CEO Dan Mendelson said in a statement. “Given the new requirements put in place by the ACA, network design is one way plans can drive value-based care and keep premiums low.”