Fox News dishonestly claimed that consumers in the health care law's exchanges would have limited options, ignoring reports that the exchanges will offer significantly more choice than is currently available in the individual market.
On Fox News' Fox & Friends, co-host Brian Kilmeade said, “You cannot force a private company to get into these exchanges. And if they all bail out like Aetna's done in a lot of states, like United's done in a lot of states, next thing you know, they're only going to have one option and it's going to be a federal option, a nationalized health care system because none of the private sector wants to get involved.” Co-host Steve Doocy agreed, claiming “That's kind of subterfuge is - a lot of people are saying that's the ultimate end game for President Obama and the Democrats, is the single-payer where the government pays for everything”:
But Fox's characterization of choices in the health care exchanges is misleading. Despite some insurers not initially providing plans in the exchanges, consumers in the majority of markets will have several health care options to choose from. The New York Times reported that, as of May, 2013, “More than 120 insurance companies have filed applications with the federal government”:
More than 120 insurance companies have filed applications with the federal government, and it appears that most consumers will be able to choose from health plans offered by five or more insurers, the administration said.
One-fourth of insurance companies proposing to offer coverage in these federal exchanges have recently entered the individual market, the administration said.
Experts on health policy said the filing of applications was only the beginning of a race to the market for insurers. After scrutinizing applications, federal and state officials could demand changes in benefits and rates, and insist that insurers expand their proposed networks of doctors and hospitals.
A recent report by the Department of Health and Human Services of exchanges in 36 states found that consumers “will be able to choose from an average of 53 different plans when the new health insurance marketplaces, also called exchanges, open on Oct. 1.”
For many consumers purchasing insurance through the individual market, options for purchasing insurance are already extremely limited. The Center for American Progress pointed out that individual insurance markets often only offer a few options and many markets are dominated by one insurer:
[I]n many states insurance markets are dominated by only one or two insurance carriers. In at least 21 states, one carrier controls more than half the market. More than half of the market is controlled by two carriers in at least 39 states. In 2007, a survey conducted by the American Medical Association found that in more than 95 percent of insurance markets, a single commercial carrier controlled at least 30 percent of the insurance market.
In addition, exchange plan choices for initial enrollment will only affect a small portion of the market. In the Washington Post's Wonkblog, Ezra Klein pointed out that “we're talking about a small fraction of the American health-care system”:
Here's the first thing to know: We're talking about a small fraction of the American health-care system. This isn't about people on Medicare or Medicaid or employer-based insurance. It's about people joining Obamacare's insurance exchanges. That's people who buy insurance on their own now, as well as some of the uninsured. In 2014, 7 million people, or 2.5 percent of the population, is expected to buy insurance through the exchanges. By 2023, that will rise to 24 million people, or 8 percent.
So we're talking about a small portion of the market.