Kaiser Health Tracking Poll: Public Opinion on Narrow Networks Malleable

As consumers weigh their options on the Patient Protection and Affordable Care Act health insurance exchanges, health plans that offer lower premiums in exchange for narrower provider networks have received an increasing amount of attention.

Looking to appeal to consumers who are seeking lower premium prices, some health insurers selling policies through the exchanges have turned to narrow networks. According to the February Kaiser Health Tracking Poll from the Kaiser Family Foundation, however, the public prefers more expensive plans with broader networks: About half (51 percent) of those surveyed said they would rather have coverage that costs more but allows them to see a greater range of physicians and hospitals, while 37 percent expressed a preference for a less expensive plan with a limited range of healthcare providers.

Still, when those who said they prefer narrow network plans were presented with the possibility that they would not be able to see the providers they typically use, the portion who continued to prefer that option decreased to 23 percent among the public overall. Meanwhile, when those who initially preferred more expensive plans with broader networks were informed they could save as much as 25 percent on healthcare costs with narrow network plans, the percentage who continued to prefer broader networks dropped to 37 percent, according to the poll.

Additionally, the poll found those who are either uninsured or currently purchase their own individual coverage — the group most likely to be in a position to take advantage of the PPACA exchanges — are more likely to prefer less expensive, narrow network plans, with 54 percent saying they would prefer such plans over costlier policies with bigger networks.

Overall, the results show the public's feelings about narrow network health plans are malleable and highly dependent on individual circumstance, says Liz Hamel, director of the Foundation's public opinion and survey research team.

"Everybody is going to make those decisions in a different way when they're faced with the actual dollar signs and the actual providers that are in those networks," she says. "Each person is faced with a different choice."

Therefore, she said it's hard to tell how narrow network plans will play out as an option available through the PPACA exchanges.

Narrow networks have already become a point of conflict for some providers. For instance, Seattle Children's Hospital — which is out-of-network for many of the new plans offered on Washington State's health benefit exchange — filed a lawsuit last year against the state's Office of Insurance Commissioner on the grounds that the state's approval of the narrow network plans doesn't meet requirements for adequate access to care. Meanwhile, Anthem Blue Cross and Blue Shield's narrow networks in New Hampshire, Maine and Missouri became the target of criticism for similar reasons, with some policymakers and excluded providers saying the narrow networks could limit access to care.