0 hey, o'reilly here, why is nancy pelosi dodging us? >> i know you're a woman of your word and i'm asking if you're going to be honoring your commitment. >> and convincing the congresswoman to honor her word, you want to see this on the next facto factor. from the world headquarters of fox news, it's "the kelly file" with megyn kelly. good evening everyone, and welcome, i'm megyn kelly, this is a "kelly file" special, what is ailing obamacare. and for months we've tracked the issues for the biggest launch of medical health care, and as a result the massive overhaul was sold to the country with these sounds like a wonky exercise in insurance 101, but this stuff is having a real impact in the lives of a lot of workers. this ceo went on line and claimed the obamacare would increase its insurance costs by $7 million a year. >> in the ceo chair let me give you an example of the decisions we have to make as a company. obamacare is an zashl $7.1 million expense for us as a company. so we have to decide whether or not to pass that expense to employees or whether to cut other benefits. >> and that is just one big firm. small businesses are facing even more dramatic challenges. david allen runs a medical billing firm in boulder, colorado, when he went to move his employees onto a state exchange plan he was looking at either a 52% hike in their premiums or telling the staff they faced a big jump in their possible out of pocket costs. david joins us now with the rest of his story. thank you for joining us. david, you have a business that that enable us to do what we need and want to be able to do for our employees. short of them coming back and offering any concessions such as allowing us to keep the health insurance plan that we had in light, and would have preferred to have kept. short of that we'll end up either having to pass along a substantial portion of the increase to our employees or we'll have to increase the deductibles or make some other substantive change. because you know again, i simply can't absorb that increase. and i don't have the luxury of passing it along to my clients. so you know one way or the other my employees will inevitably end up participating at a higher level financially going forward if we don't get some kind of relief from the federal government. >> we've heard that story time and time again. david, all the best to you. well, thank you very much. >> we're also hearing similar stories and similar challenges for people who buy insurance directly from their exchanges as opposed to their employer. and he signed up, learn iing th doctor who was treating his cancer was not part of his new plan. and in california, the l.a. times did a feature story on a woman who got coverage on the state exchange after previously being denied for a pre-existing condition. good news, except for when she went to see the specialist for numbness in her arms the doctor wouldn't take the plan, or the next one, or the next one after that. of course if she were watching the kelly file back in november she would have seen this prediction from the head of the large doctor's group based in california. >> so what will happen then for those californians who find themselves in a place where there is no choice but to deal with the exchange. >> well, we're in a situation where the physicians are making a decision whether or not to participate. and by plans, only contracting with a smaller number of doctors for some of the exchange products. if you put enough people in those plans and don't have enough doctors participating you end up with a bottle neck, which means you're not doing what this was all about, improving access to care. >> trace gallagher joins us with more from l.a., trace? >> and so megyn, the mantra might now be if you thought you kept your doctor you may want to double check. you have thousands of doctors leaving the health care exchanges. they are opting out because the reimbursement rates are simply too low. for example, we know an orthopedic specialist who performed a surgery and was paid a few hundred dollars, not enough to cover his expenses, so he opted out. in early 2012 a doctor who wants to remain anonymous was sent a contract from blue shield saying quoting here, your participation under the development of blue shield will require you to sign the agreement. well, the doctor didn't sign the agreement because he didn't want to be in the network. in october of 2012, blue shield sends another letter saying quote, your completion of the agreement is critical to accessing these new business opportunities yet we've not received your signed agreement. well, because they didn't receive it because the doctor doesn't want to be in that network. three weeks later he gets a third letter. this one says quote, we are writing to inform you we plan to include you in our practice in the individual exchange network. so now he is in, even though he didn't sign up and the doctor can't get out. he actually had to pay a lawyer several thousand dollars to get him off the list. and dr. mark siegal says this is part and parcel of what is happening across the entire country, listen. >> the whole goal of obamacare was to provide care for people who didn't have it. but the narrow networks are going to create a situation where those who need care the most may not be able to get it because their doctor is not participating. because they can't find a hospital that provides the service. so the end result will be people not getting care they need. >> and the bottom line here is that most people will not find out that their doctor is not in their network, megyn, until they actually need to use that doctor. >> all right, trace, thank you. well, when the reports of problems with the exchange plans first came up we asked for e-mails, tweets or personal experiences on our facebook page and we're still collecting them. if you follow me on twitter it is @megynkelly. this family lives in lincoln, nebraska, mom and dad are self-employed and they signed up for a platinum level plan on the exchange. once they confirmed they were in fact covered they cancelled their old insurance and everything was fine, they thought until their son tore a ligament and needed medical attention. well, when the pharmacist told them they had no insurance, things got more complex from there. samantha peace is with us now, so you were one of the people who believed you were covered, or to be more specific your children were not, the pharmacist says what to you? sorry, ma'am, there is no record of any coverage for you? >> yes, that is exactly what they said. and i was extremely shocked. and i have spent the past three weeks talking to senators and congressmen, and health and human services and no one seems to be able to figure out how to get my children back on the plan. >> i am just curious, this is such a mess for so many people. when you find out they insured half your family and none of your children who do you call? like how do you start that process? >> that is a very good question. i started off with calling healthcare.gov, and then i called senator fortenberry -- or congressman fortenberry's office. e-mailed the white house. i tried to reach out to any representative that would help me. and they have tried to find people who could help me and steer me to the state insurance department and eventually to health and human services. they want to push everyone onto medicaid. all of these children onto medicaid and i just refuse for my children to go on medicaid. >> so hhs's response is just put your children on medicaid and for you that is not an acceptable option. why? >> not at all. i don't want to be on public assistance. and actually, almost every person at every corner has asked me to be on medicaid just to have my children insured. and i said absolutely not. i signed up for a platinum plan and i will have them insured under that. i did have to go out and get another private insurance plan so i am paying two premiumsnow. >> this is just flabbergasting to me, samantha, here we are after the abobotched rollout pl here you are trying to get the plan. and people ask you about it. healthcare.gov, what do you say? >> well, healthcare.gov is a complete nightmare. i have probably spent 20 hours talking to them on the phone or on with their chat. and everybody knows a different thing, but nobody understood my case or knew what was going on. and nobody can help me. i mean, i talked to someone representing the white house, senators, congressmen and nobody knows the answer. it is because it is a problem with the law so my children still don't have health care through the platinum plan. >> this is unbelievable. we're going to continue to follow your story and i hope you stay in touch with us to let us know how it goes. this should not have to happen, you should not have to contact your senator and the congressman and the white house and the health and human services department in order to get health care coverage that you paid for, for your children. >> i know. >> thank you, samantha, all the best to you. >> that is very true. thank you. >> can you believe this, people? can you imagine having to go through that? that is outrageous. send me your thoughts on facebook.com/thekellyfile. and of course there are the ongoing security issues with healthcare.gov, we'll take a look at those, plus? >> a look at the white house in damage control mode and what this means for the 2014 mid-term. and a marketing blip, first keg stands and pajama boy, now, talking pets. who is responsible for all of this? and what is it costing us? ladies iyou have over active bladder, imagine not being near this so often. imagine not getting out of bed again and again. and imagine finally taking control of your symptoms with the oxytrol for women patch. now fda approved as otc. it's safe and effective when used directed. and it reduces frequency, urgency, and accidents. if you have questions, call 1-888-oxytrol for a one on one discussion with anowledgeable woman to learn more. take control with oxytrol for women. sunny or bubbly? cozy or cool? 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