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JAMA Forum Archive, 2012-2019: Health policy commentary from leaders in the field
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Much Ado About Narrow Networks

The bumpy rollout of the health insurance coverage expansion by the Affordable Care Act (ACA) through private insurance exchanges ultimately exceeded enrollment expectations. The question is no longer whether the public will embrace these new health insurance marketplaces, but whether individuals are happy with their ability to use their new plans to access care.

In several states, there are concerns that the networks of physicians available through health plans sold in insurance exchanges are sometimes too narrow, limiting access to care and disrupting long-standing patient-physician relationships for some enrollees. The concern has surfaced mainly in the form of anecdotes, with no reliable estimate of how many individuals are negatively affected. But physician organizations have been quick to ring the alarm bell on behalf of patients and, presumably, their own self-interests.

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