This isn't the only factor that could make the Arkansas plan unattractive, particularly to those allegedly aided by the proposal. The Journal also reports plans sold on the exchanges will typically provide a more limited choice of providers “in an effort to bring down premiums.” In some cases, the limits will be dramatic. An official with Blue Shield of California said their provider network for exchange plans will be only around 45 percent of its traditional PPO plans.
So relatively low-income citizens could not only face a much briefer doctor's office visit, but fewer doctors. When HMOs used provider limits to control costs in the 1990s, it prompted a public backlash. It's hard to believe that it won't happen again.
And many insurers may not even participate in the exchanges because Obamacare's benefit-and-rate mandates make them financially unattractive. UnitedHealth Group Inc. CEO Stephen Hemsley has said his company may significantly limit its participation in exchanges due to concerns about financial viability.
Yet cost controls that reduce consumer access and choice in the health care market are almost certain to continue under Obamacare because several parts of this unwieldy law dramatically increase overall insurance costs. In fact, some groups could face premium increases of up to 169 percent, according to estimates.
Oklahoma officials should carefully monitor the Arkansas plan to see if it benefits patient care without wrecking state finances.