President Obama's sales pitch for Obamacare included repeated promises that, under his proposal, "if you like your doctor, you can keep your doctor. Period." But it turns out that, for some people, that's not true.
Obama doesn't make much effort to deny this. Instead, he tries to shrug off the blame.
The gist of Obama's excuse for why some people can't keep their doctors under his health care overhaul is that, despite his promise that it's not really his fault. Don't blame the president, because it's all just a natural part of the health insurance marketplace.
Asked in a recent WebMD interview about limited access to doctors under the law, Obama responded, "these are private insurance plans, which means that they're going to have networks. That's pretty much true of any health insurance plan you've got right now…that's not unique to the Affordable Care Act."
What it comes down to, he said, is people making choices.
"For the average person, for many folks who don't have health insurance initially, they're going to have to make some choices. They might have to end up switching doctors in part because they're saving money. But that's true if your employer suddenly decides this network is going to give you a better deal. 'We think this is going to help keep premiums lower. You gotta use this doctor as opposed to this one.'"
Well, yes, people in the private health insurance market have to consider tradeoffs and make their own choices, as do employers. But the choices about plans and coverage networks facing many people now have come about as a direct result of Obamacare, which, by design, shook up the market for individual health coverage.
Thanks to Obamacare, the health plans—and the networks and doctors that went along with them—that millions of people had and liked are no longer available. Those people had made their choices, and then Obama took their choices away, after promising that he wouldn't. The choice those people have now is a choice that he forced upon them, that many didn't want, and that he said they wouldn't have to make. (There's also some indication that the networks for plans in the exchanges have tightened in response to regulations and incentives built into the law.)
Meanwhile, the plan choices offered through the law's exchanges are, in many cases, rather limited. In 515 mostly rural counties in 15 different states, there's only one health insurer selling coverage, according to The Wall Street Journal. In the vast majority of those counties, the local Blue Cross & Blue Shield plan is the only option.
Obama acknowledges as much, while attempting to frame it as good news. "The good news" he says, "is, in most states, people have more than one option." Put another way: This is about choice. But in some places, there isn't one. The only choices Obama likes are the ones that he allows.