When Joe went to buy new coverage in January, there was only one option on the exchange: Blue Cross. The company was offering a plan called “Blue Value,” created specifically for exchange customers. The plan is designed to provide general primary care, and little else. The idea is to prevent people from going to the ER for things like the flu but it does little for patients with more serious health concerns.

Under his new plan, Joe lost access to all of his regular doctors, including the specialists he had been working with to diagnose and treat his back pain, as well as the Carolina Medical Center (CMC), the major health-care system in Charlotte that runs 15 hospitals and nearly all the outpatient surgery centers in the area. CMC is the must-have provider network for all of North Carolina south of Raleigh, but his “Blue Value” plan didn’t include it.

What’s more, the new plan denies all radiofrequency ablation procedures, no matter what.