In the past five years, the federal government has made a number of modifications to the ACA exchanges. One of the biggest changes is that individuals can now choose to either forgo insurance altogether or purchase alternative insurance options such as short-term health plans.

Despite this, enrollment in the exchanges has remained robust with only a 3.4% decline between 2018 and 2019, since the vast majority of consumers continue to actively select their plans.

ACA consumers have historically shown a willingness to give up access to a broad network of providers for lower premiums. But, as plan premiums converge, consumers are increasingly considering network coverage as they select plans. In turn, plans are crafting products with artificially broad network configurations that either limit out-of-network benefits or enlist nontraditional providers such as telehealth providers and retail clinics.

Products like these are initially appealing to consumers, but plans will need to be careful. Members are likely to become frustrated with access restrictions as they often lead to unexpected health care costs from out-of-network use.

Plans can balance the initial appeal of these seemingly broad, restrictive, and low-cost products by simplifying the navigation process as members use the product.

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