We’re getting into open enrollment season for Obamacare yet again and much of the focus has been on the declining patient participation rates, limited options for carriers and rising costs. But there’s one other aspect of the overall healthcare puzzle which has been somewhat ignored. If you like you doctor you can keep your doctor, unless of course your doctor doesn’t want to participate in the system anymore. (MRCTV)

The number of physicians who say they’re accepting health insurance plans offered on Obamacare’s federal and state marketplaces has plummeted nearly 20 percentage points, creating yet another crack in the president’s rapidly buckling health care law.

According to a recent survey by SERMO, a social network for physicians, about 57 percent of doctors said they won’t be taking new patients insured by the plans next year. That’s down about four percentage points from last year, when 61 percent of physicians said the same, Forbes reported Monday.

But a similar survey conducted by the Medical Group Management Association back in 2014 showed that at the time, 76.5 percent of physicians said their practice were accepting insurance plans offered on the state and federal marketplaces.

MRC does the math for us and finds that 19.5% of participating doctors have begun saying no thanks to patients using Obamacare since the program’s inception. This doesn’t mean that you won’t be able to find a doctor, but there’s a one in five chance that it won’t be “the doctor you liked” four years ago when this all kicked off. This lack of choice is one more layer on a very sour tasting cake which will be leading many potential customers – particularly the young and healthy ones – to just give the entire thing a pass and pay the penalty at tax time.

It’s those younger consumers who the program desperately needs and they are precisely the ones being turned off by another feature of the program. As The Hill reports this week, one of the biggest selling points of the original scheme which was championed by the White House is turning out to be the deciding factor for so many of these millennials who opt not to shop on the exchanges.

Because of the healthcare law, the White House says nearly 3 million young people under the age of 26 have been able to stay on their parents’ insurance plans and don’t have to shop for coverage on HealthCare.gov.

That’s about double the number of young people between the ages of 18 and 25 who are currently covered through the exchanges.

“I think that is an argument that has some validity,” John McDonough, a senior adviser to the Senate committee that wrote ObamaCare, said in an interview.

This is one of those things you’d think everyone might have seen coming. If the younger folks in the 18 to 26 age range are able to be covered on their parents policies, why would they go shop for an expensive exchange plan on their own? The group rate is lower so they could just kick in some of the premium costs to mom and dad, thereby assuring that they have insurance but don’t need their own plan.

Gee… who could have predicted this unexpected development?