NCPA - National Center for Policy Analysis

Are There Enough Doctors for the Newly Insured?

January 3, 2014

Signing up for health insurance on the new state and federal exchanges was supposed to be the easy part of the Affordable Care Act (ACA). The really dicey part, lots of health policy experts have always feared, would come on January 1, when Americans who had enrolled in health insurance for the first time under the ACA were likely to discover that having coverage doesn't guarantee them easy access to a primary care doctor, dentist or mental health professional, says Stateline.

  • According to the Health Resources and Services Administration, the federal agency charged with improving access to health care, nearly 20 percent of Americans live in areas with an insufficient number of primary care doctors.
  • Sixteen percent live in areas with too few dentists and a whopping 30 percent are in areas that are short of mental health providers.
  • Under federal guidelines, there should be no more than 3,500 people for each primary care provider; no more than 5,000 people for each dental provider; and no more than 30,000 people for each mental health provider.
  • According to the Association of American Medical Colleges (AAMC), unless something changes rapidly, there will be a shortage of 45,000 primary care doctors in the United States (as well as a shortfall of 46,000 specialists) by 2020.

In some ways, the shortage of providers is worse than the numbers indicate. Many primary care doctors and dentists do not accept Medicaid patients because of low reimbursement rates, and many of the newly insured will be covered through Medicaid. Many psychiatrists refuse to accept insurance at all.

There are various reasons for the shortages. Certainly a big contributor is the aging of the baby boomers. The retirement of many doctors in the boomer cohort is compounding the problem. 

  • The federal government estimates the physician supply will increase by 7 percent in the next 10 years.
  • But the number of Americans over age 65 will grow by about 36 percent, according to the U.S. Census Bureau.

Money and work-life balance are also factors in the shortage. Primary care physicians, for example, earn around $3 million less than their colleagues in specialty fields over the course of their careers and they are required to work many nights and weekends.

Source: Michael Ollove, "Are There Enough Doctors for the Newly Insured?" Stateline, December 30, 2013.


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