As President Donald Trump and Congress debate what is next for the Affordable Care Act (ACA), the future of narrow networks is one of the many talking points.  Since June of 2009, when former President Barack Obama said, "If you like the doctor you have, you can keep your doctor," physician choice has been a point of contention.  So what should be the future of narrow networks under the ACA's three Rs: repeal, replace and, now, repair? 

Narrow networks: designed to save costs… 

Narrow networks arose primarily to control costs by giving carriers negotiating power: we will deliver more patients to you, but pay you less for each.  Net-net, you win.  Cost savings were also achieved by excluding outlier physicians and hospitals. 

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