How States Are Ensuring "Narrow Network" Health Plans Meet Patients' Needs
“Narrow network plans”—which offer limited networks of health care providers as a way to constrain costs—are common in the new health insurance marketplaces, where plans compete on price. While narrow network plans existed before the Affordable Care Act (ACA), they have garnered attention recently because of concerns about whether they might jeopardize patients’ ability to get needed care or expose them to out-of-network costs. <br /><br />
In a new issue brief, Justin Giovannelli and colleagues at Georgetown University explore how states are applying the ACA’s national standards for ensuring consumers have good access to providers. The law’s regulations give states leeway in determining if an insurer has complied with the rules and to enforce additional, state-specific network rules.