As a coalition representing over 55 million patients, Partners for Better Care welcomes the Administration’s move to rate health insurance plans based on the number of doctors and hospitals they include in plan networks. We recognize that networks are a vital tool for contracting with high quality providers and lowering costs. But many challenges exist to ensure that patients have access to the necessary range of healthcare providers within their networks and that all providers that touch a patient are included in a provider network. We call for alignment of network adequacy requirements with patient needs, especially with respect to specialist care for the most vulnerable, while carefully balancing the need of plans to create networks to better control the quality and cost of their providers.
In addition, maximum out-of-pocket costs for consumers under the Affordable Care Act will increase next year to $7,150 for an individual and $14,300 for a family. We remain concerned that such high out-of-pocket costs, in addition to high premiums and deductibles, will result in health coverage being treated as catastrophic insurance by many patients. We are committed to finding a solution to ensure that patients do not delay or forgo medically necessary care and treatments because of deductibles, co-pays, coinsurance or other out-of-pocket costs.