Frustrated By The Affordable Care Act, One Family Opts Out : Shots - Health News Many new plans created under Obamacare have consumers and doctors scrambling to figure out which providers accept which plans, and what services are covered.
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Frustrated By The Affordable Care Act, One Family Opts Out

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Frustrated By The Affordable Care Act, One Family Opts Out

Frustrated By The Affordable Care Act, One Family Opts Out

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  • <iframe src="" width="100%" height="290" frameborder="0" scrolling="no" title="NPR embedded audio player">
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Now that the exchanges are running, people are learning just what they signed up for. They're using their new coverage - or at least trying. Some find it frustrating, like the couple who spoke with Carrie Feibel of Houston Public Media.

CARRIE FEIBEL, BYLINE: Last summer Nick Robinson lost his job working as a youth pastor in Dallas. He also lost the health benefits - coverage for himself, two young daughters and his wife Rachel, a wedding photographer. He wasn't too nervous at first because everyone was healthy. But then Rachel found out she was pregnant.

NICK ROBINSON: It's one of those times where you hear the news and there's this immediate sense of joy and excitement - like, yay, a new kid. That's awesome. What are we going to do? How are we going to pay for this? This is intense.

FEIBEL: The Robinsons didn't qualify for Medicaid. And they couldn't afford a $15,000 hospital birth. Summer crept into fall. And right around then, Nick started hearing the buzz about the Affordable Care Act.

N. ROBINSON: I was like, oh, here's the answer. This is simple. This is the cheaper insurance plan. There's no pre-existing condition stuff.

FEIBEL: Nick picked a plan just for his wife. It was a Gold HMO plan through Blue Cross Blue Shield for $375 a month. Nick printed out a list of obstetricians from the plan's website.

N. ROBINSON: So I handed it over to Rachel, fully confident, fully feeling like I had come through for my wife. This whole Obamacare thing was going to work. Here you go. Have fun.

FEIBEL: Over two days in January, Rachel says she called every doctor on the list of 28. According to her, most of the practices told her they didn't take the plan in one way or another.

RACHEL ROBINSON: Some would just come out - right out and say, we don't take Obamacare. Or the best one was, the doctor takes it here at the practice. But whatever hospital you use that we go to and do all of our deliveries through does not take that insurance.

FEIBEL: She says there were other issues, too. Some of the doctors said they wouldn't see her because she was too far along in her pregnancy. And some practices did take the HMO, but they operated as a rotating clinic. And Rachel wanted to see the same doctor every time.

R. ROBINSON: It was mind-numbing 'cause I just was sitting there thinking, I'm paying close to $400 a month just for me to have insurance that doesn't even work. So what am I paying for?

FEIBEL: Nick got even more frustrated when he called Blue Cross and was simply told those doctors should be taking the plan.

N. ROBINSON: How could this not be working? The United States government has set this up. It's this whole big deal. There's commercials everywhere saying we need to use this. And they're just saying, no, no, no. And that just made me so mad.

FEIBEL: A spokesman for Blue Cross Blue Shield in Texas, Louis Adams, says he went down that same list of 28 and confirmed that most of the doctors do take the HMO.

LOUIS ADAMS: We're committed to helping our new members understand how to get the most from their coverage, while also working with doctors and hospitals to inform them of the range of coverage options we have available.

FEIBEL: Whatever the miscommunication was, the Robinsons felt lost. It was January, and Rachel was due in April. And so they started considering a midwife, an option they had previously rejected.

N. ROBINSON: Both of us quickly, our answers to that were, absolutely not. That's insane. We're not going to go to some crazy witch-doctor lady who's going to make us get in a giant tub. Those are the crazy people. We're the normal people. We want to have our birth in a hospital.

FEIBEL: And it was risky, too. Rachel had already had two C-sections, but a homebirth would mean trying to deliver vaginally. But soon the Robinsons saw a midlife as the solution. Rachel met one and loved her. And out-of-pocket, a homebirth would cost only $4,000. And so they dropped their new plan. They just stopped paying the premium. They signed on to the midwife.

N. ROBINSON: We're so happy with where we are now. But this is not OK. And I'm extremely confident that that was not what the architects of this plan had in mind.

FEIBEL: Nick found an alternative for the whole family, a nonprofit Christian-oriented medical cost-sharing plan. The Robinsons pay cash upfront and request reimbursement later. On April 28, almost two weeks after this interview, Rachel gave birth at home in that giant tub with no pain medication.

N. ROBINSON: There he is.

FEIBEL: A healthy baby boy named Cash. Nick says that's for Johnny Cash, mind you, and not the midwife's fee. For NPR News, I'm Carrie Feibel in Houston.

INSKEEP: OK, Eric Whitney and Carrie Feibel's stories are part of a reporting partnership with NPR, local member stations and Kaiser Health News. We're glad you're with us on your public radio station, which brings you MORNING EDITION and is with you throughout the day. You can continue to follow NPR News this afternoon on All Things Considered and of course we're on social media. You can find us on Facebook. We're on Instagram. We're on Twitter @MorningEdition, @NPRInskeep and @NPRGreene.

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