NYT: Republicans contend that the Affordable Care Act is a failure because many of the plans sold on the online health exchanges limit a consumer’s choice of doctors and hospitals. Many plans do, indeed, limit choice — deliberately so, to keep premiums down. But a vast majority of consumers can almost always buy a plan with a broad array of doctors, hospitals and other providers if they are willing to pay more for the policies.

The issue is one of priorities: Is it more important to keep premiums low or to have access to a broad array of doctors to choose from? A poll in February showed that many people, especially the previously uninsured, think lower cost is more important.

The technique of using limited networks to control costs has been around for years. It became especially useful with the passage of health care reform, which eliminated or made illegal several other cost-control tactics, such as refusing to insure people with pre-existing conditions.

One industry survey found that 90 percent of the individuals using the exchanges had access to a broad network plan, with no difference in quality between the broad and narrow plans. Another industry analysis found that narrow network plans had premiums 5 percent to 20 percent lower than broader plans. State and federal regulators need to monitor how well the plans are performing and if they fail to serve the needs of their customers.