Federal officials will begin rating health insurance plans under the Affordable Care Act based on how many physicians and hospitals are included in their network, according to a report from The New York Times.
Here are eight things to know about the initiative.
1. The initiative is part of new rules for health insurers selling coverage through the ACA exchanges in 2017.
2. Under the rules, insurers will be able to sell health plans with narrow networks of providers, but consumers will know if a network is narrow because the federal officials will attach a label indicating the network size for each plan sold on HealthCare.gov, according to the report. The new ratings will also indicate how the network size for a plan compares with the network size of other plans in the same geographic area, according to The New York Times.
3. The initiative comes in response to consumer complaints. Consumers have grumbled as many ACA health plans provide a limited choice of physicians and hospitals, and some insurers have narrowed their networks this year, according to the report.
4. At the same time the federal government is starting to rate health insurance plans, it is also increasing the maximum out-of-pocket costs for consumers under the ACA next year to $7,150 for an individual and $14,300 for a family, President Barack Obama's administration said, according to the report. This year, it is $6,850 and $13,700, respectively.
5. Consumer advocates said those out-of-pocket costs, which include deductibles and co-payments, but not premiums people pay for insurance, could pose a significant financial burden for middle-income people who need a substantial amount of care, according to the report.
6. HHS spokesman Ben Wakana said the new ceiling on out-of-pocket costs is based on a formula laid out in the ACA, and that before the health law, people with cancer or other serious illnesses could end up with hundreds of thousands of dollars in medical bills, and the law provides new protections.
7. The report also points out that people with low incomes can obtain discounts that reduce their deductibles and other out-of-pocket costs if they choose midlevel silver plans.
8. Additionally, under the new rules, consumers using the federal marketplace will be able to get assistance throughout the year from insurance counselors financed by the government, whose duties will include teaching people how to use insurance, appeal denials of coverage and obtain exemptions, according to The New York Times.
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