Some Doctors Won’t Accept Exchange Insurance

“A majority of physician practices (55.5%) hold an “unfavorable” or “very unfavorable” view of the impact the Affordable Care Act’s (ACA) health insurance exchanges will have on them, a survey of more than 1,000 group practices showed.”

“Almost as many (40.2%) said they were still evaluating their options or planning not to participate with insurance products sold on the exchanges…”


“Those practices that said in the survey that they wouldn’t be participating cited concerns about administrative and regulatory burdens (64%), concerns about patient collections because of high deductibles (61.9%), and low reimbursement (59%) as their top concerns.”

“While little formal data exist yet, some providers have noted that payment rates for ACA exchange plans are significantly below those of traditional commercial payer plans.”


“Michael Morrisey, PhD, professor of health economics and health insurance at the University of Alabama in Birmingham, called the low payments for physicians one of the great problems of the ACA’s rollout.”


“The law allows consumers 3 months of not paying their premiums before they are dropped from their plan. However, once they are dropped, it’s the physician practice that must recoup payments from patients as insurance companies won’t process those claims.”


Docs Skeptical of ACA Exchanges, Survey Shows
David Pittman
Published: Oct 7, 2013

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