Remember when President Obama said that if you like your doctor, you can keep your doctor? That’s not true for millions of Americans under ObamaCare. Now Obamacare’s architect, Ezekiel Emanuel, is now sayingthat the president really meant that, if you like your doctor, you can start paying a lot more for insurance in order to keep that doctor.

Which is a way of saying that under the Affordable Care Act, coverage might be affordable for some Americans, but only if they accept a level of care they didn’t want.

What about hospitals? New evidence is in the Financial Times. Plans that meet Obamacare’s standards exclude many of the nation’s leading hospitals:

“The majority of insurance plans being sold on the new healthcare exchanges in New York, Texas, and California, for example, will not offer patients’ access to Memorial Sloan Kettering in Manhattan or MD Anderson Cancer Center in Houston, two top cancer centres, or Cedars-Sinai in Los Angeles, one of the top research and teaching hospitals in the country.”

These hospitals aren’t costly because they’re a luxury. They are the best at what they do:

“‘We’re very concerned. [Insurers] know patients that are sick come to places like ours. What this is trying to do is redirect those patients elsewhere, but there is a reason why they come here. These patients need what it is that we are capable of providing,’ says Thomas Priselac, president and chief executive officer of Cedars-Sinai Health System in California.”

A spokeswoman for the Mayo Clinic, Kathleen Harrington, put it well:

“‘I don’t think there is any doubt that a significant portion of the Mayo base are very sick patients. You don’t come here for primary care. We do treat the sickest of the sick. We do experimental treatment. This is where you come for innovative treatments for life threatening illnesses,’ she says.

“‘If healthcare, the full spectrum from primary to top speciality care, becomes commoditised, it becomes a concern for the American healthcare system,’ she adds.”

It’s important to remember that specialized care at top hospitals wasn’t the privilege of a few lucky people before now. My daughter was born with a heart defect that required surgeons to rebuild her heart the day after her birth 29 years ago. That was possible because she was rushed to another hospital, a center of excellence. As I put it in the Wall Street Journal:

“She wasn't saved by a bureaucrat, and no government mandate forced her parents to purchase the coverage that saved her. Instead, her care was provided under a run-of-the-mill plan available to every employee of an Oshkosh, Wis., plastics plant.”

As ObamaCare forces more people to lose the coverage they chose – and when it causes millions of employees to be dumped off their employers’ plans in a year – we may find that top-notch care for the sickest people will be harder to get.