"[O]ne study or comparison after another from state to state [compares] the lowest, or second lowest cost Silver plans ... to existing health insurance rates and [brags] about how low they are. But what is often happening here is that these lowest cost and second lowest cost plans are likely the most limited access plans available.... What many health plans have done is to put their lowest cost plans on the exchanges and have often built new very narrow network plans just for the exchange.... What is also happening is that health plans are expecting that higher income people will not be eligible for a subsidy and will come directly to the health plan for the better coverage when it isn't available on the state exchange."

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