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A similar situation frustrated Mary, an African-American woman small businesswoman who asked MailOnline not to publish her last name. She was leaving the Inova Alexandria Hospital in Alexandria, Virginia with two family members.

‘I had chest pains last night, and they took me in the emergency room,’ Mary said. ‘They told me they were going to admit me, but when I told them I hadn’t heard from my insurance company since I signed up, they changed their tune.’

She told MailOnline that a nurse advised her that her bill would go up by at least $3,000 if she were admitted for a day, and her doctor told her the decision was up to her.

‘Why is this so complicated?’ she asked. ‘I had my own private insurance last year, but they cancelled me in November. I’m not sure which end is up.’

Private industry estimates put the number of policy cancellations as high as 4.7 million in the last quarter of 2013, mostly involving health care plans that didn’t meet the Affordable Care Act’s strict minimum standards.

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