By: MARY ELLEN SCHNEIDER,
Millions of Americans can now purchase health insurance through the federal and state exchanges. But while interest is high, no one knows for sure just how many people will end up enrolling in a plan.
And the bigger question for physicians is how many patients will show up in their offices early next year when coverage starts.
The answer may depend on where you live, according to Paul B. Ginsburg, Ph.D., an economist and president of the Center for Studying Health System Change.
Multiple factors dictate demand
States with the highest number of uninsured residents are likely to have the most people entering the insurance market, Dr. Ginsburg said. But the expansion of Medicaid is also a factor.
Texas has one of the highest rates of uninsurance in the nation, but is not expanding its Medicaid program. Arkansas, Arizona, and New Mexico – all with high rates of uninsurance – are.As originally enacted, much of the increased insurance coverage under the Affordable Care Act was to come from the expansion of Medicaid. That changed when the Supreme Court gave states the choice of whether or not to expand eligibility for their programs; so far 25 states are actively moving forward with expansion.
The exchanges will allow some patients in the system – who are currently without coverage – to gain insurance, said Dr. Reid B. Blackwelder, president of the American Academy of Family Physicians (AAFP). This should provide some relief for struggling physicians, he said.
In a survey of members, the AAFP found that family physicians provide free or reduced rate visits for uninsured or underinsured patients an average of 10 times a week.
“A lot of the folks that will get insurance are already in the system,” Dr. Blackwelder said. “They are already being cared for, but cost the system money. This will actually help.”
Tough for solo practices
So who will be coming through the front door? Experts say it will be both the sick and the healthy.