State Variation in Narrow Networks on the ACA Marketplaces

A state-by-state analysis delves into how much choice consumers have over the doctors they see, if they purchased insurance through Affordable Care Act (ACA) marketplaces. The analysis provides information on the occurrence of narrow networks for regions within states as well.

The Issue

In four states, at least three in four marketplace plans have narrow networks that cover 25 percent or fewer of all area physicians. Thirteen states have no plans that so narrowly limit the physicians who are covered.

Key Findings

States with the highest percentage of narrow networks in marketplace plans are:

  • Georgia (83%)

  • Florida (79%)

  • Oklahoma (78%)

  • California (75%)


Now that insurers can no longer discriminate against people with pre-existing conditions and must cover a wide range of services, the authors say plans are using narrow networks to keep premium costs down and remain competitive as consumers shop for coverage.

About the Grantee

The Leonard Davis Institute of Health Economics (LDI) is the University of Pennsylvania’s center for research, policy analysis, and education on the medical, economic, and social issues that influence how health care is organized, financed, managed, and delivered.