Obamacare applicants across the country are finding their premiums are tripling, their favorite doctors aren't available, the physicians they can see are often far away and many prestigious hospitals offering specialized care are off-limits to them, according to a Washington Examiner survey of health insurance agents and brokers across the country.

Agents associated with the National Association of Health Underwriters were contacted in 16 cites across the country.

The agents were all certified by state insurance regulators to sell health insurance policies within and without the Obamacare exchanges.

Their responses provide an alarming picture of the profound changes Obamacare is forcing on patients and health care providers.

In parts of California, for example, low reimbursement rates have resulted in a doctor rebellion, as nearly seven out of 10 doctors refuse to participate in the exchanges.

San Diego broker Neil Crosby told the Examiner that "65 to 70 percent of the providers have declined the reimbursement schedules the carriers are offering. They will not be providers in the exchange marketplace.”

Similarly, agent David Fear in Sacramento said, "Roughly a third of the doctors are going to be accepted in the networks. I’m finding very few specialists in either the Anthem or Blue Shield networks.”

Larry Harrison, an agent in Las Vegas, said the “lion’s share” of doctors there are staying away from the exchanges.

On the other side of the country, broker Carol Taylor of Roanoke, Va., estimated that participating doctor networks there are shrinking by 70 percent in the exchange plans.

Meanwhile, nationally known health insurance providers like United Healthcare, Aetna, Cigna and Coventry are staying out of the Obamacare exchange marketplaces.

Other well-known companies such as Blue Cross Blue Shield are in, but are sharply narrowing their networks to exclude many doctors, as well as elite hospitals.

As a result, well-known hospitals like Los Angeles' Cedars-Sinai, New York's Memorial Sloan-Kettering and the NewYork-Presbyterian Hospital will be out of reach for many exchange patients.

In Naples, Fla., Physicians Regional Hospital will not be available to exchange enrollees. Its parent company purchased the former Cleveland Clinic's Florida facility in Naples in 2006.

In Georgia, Humana exchange patients are discovering the insurer operates only one approved hospital in the entire state.

The changes wrought by Obamacare are especially hard on patients in rural areas because the new program often puts available medical help far away.

Roanoke's Taylor said, “just an hour away, in Lynchburg, there is a lot of disruption in that area. They have no providers in that area. They have to drive an hour to see a physician.” None of Lynchburg's three hospitals are available to exchange patients.

Fear in Sacramento estimated that Anthem exchange customers who live in the Sierra Nevada foothills will find their closest hospital is 50 miles away.

David Mordo, a Fair Haven, N.J, agent, said his customers wonder if they will have any access to their doctors:

“That’s obviously a concern. Will my doctor be in? Will my hospital be in? If my hospital is not in, how long do I have to travel to go to a hospital that is in?”

While health care services for Obamacare customers are being curtailed, premiums are skyrocketing for many of them.

Mark Brown, an agent in Joliet, Ill., said, “if they enroll in the Blue Cross Choice, it’s smaller, much smaller than what it was before. But the prices of these plans have gone up considerably, about 30 to 40 percent."

Donna Hill in Duluth, Ga., just outside Atlanta, said premiums are 80- to 100-percent higher than those under current policies that offered wider networks.

Gregg Westcott, an agent in Grand Rapids, Mich., said his customers are seeing $300-per-month premiums mushrooming to $900 and $1,400.

Agent Larry Pahlke’s Chicago customers are seeing monthly premiums increase from $425 to $750. “These are really scary numbers for a guy like me,” Pahlke said.

The news isn't uniformly bad. Connecticut’s medical society sponsored the health co-op there, so there is little likelihood of a doctor shortage there. And Utah's doctor participation rate is 92 percent.

But New Jersey's Mordo echoed comments from many of his colleagues across the country when he told the Examiner that “outside the exchange, the provider networks are large. Their network of doctors and hospitals is formidable. It’s very formidable. Inside the exchange, we’re liable to see reduced providers and hospitals.”

The assessments of agents and brokers interviewed by the Examiner are necessarily limited to their particular markets and so should not be viewed as constituting a comprehensive perspective.

Even so, they provide important insights into how the American health care system is being changed by Obamacare.