The vast majority of states…operate under a “clearinghouse model.” In that scenario, any health plan that meets a set of criteria gets approval to sell on the health insurance exchange. All 33 state exchanges that the federal government will run operate under this clearinghouse model. So do 10 of the 18 state-run health exchanges (this includes the District of Columbia). Two states, Kentucky and New Mexico have not, according to Kaiser Family Foundation, addressed the issue yet.
In the final count, only six states are currently “active purchaser” states, so nationwide might not be as low as California’s projections suggest.If that’s not enough to temper any lingering optimism, consider that the state had to make some significant tradeoffs to keep rates so low, as an LA Times piece reveals. Under the plans offered on the exchange, consumers will have access to far fewer doctors and hospitals. Blue Shield of California, for example, will give its exchange customers access to only 36 percent of its regular physician network:
“If we want to keep costs down, something has to give,” said Betsy Imholz, special projects director for Consumers Union. “At first blush, it seems like Covered California has negotiated some good deals, but in any given community we will see how this network issue plays out.”
Given the limitations in access, California’s cost savings may not benefit as many patients as promised. With Obamacare, even the good news is often bad.