ObamaCare's Impact on the Health Care Workforce

March 28, 2014

The Affordable Care Act (ACA) will intensify the United States' health care professional shortage, says Amy Anderson, a graduate health policy fellow at the Heritage Foundation.

The ACA is projected to expand health insurance coverage to 34 million people, but expansion of coverage is very distinct from expansion of care.

  • The U.S. health care workforce has had a shortage of workers for several decades. The ACA will flood the strained system by unleashing millions of newly insured into doctors' offices across the country.
  • Training health professionals takes many years, and unless more students begin graduating from nursing and medical schools (and currently, medical schools are unable to enroll the number of workers needed to guarantee access) Americans are going to see longer wait times and have difficulty accessing health care providers. For those that do get access, they will face higher costs along with shorter time with their doctors.
  • Logistically, our current health care resources will not be able to meet the demand created by the ACA. Every health care profession is expecting shortages, as projected supply is not matching up with population growth and aging. The incidence of chronic disease increases with age, thereby increasing the amount of required care. By 2025, almost half of all Americans will suffer from a chronic disease.
  • Health professionals are highly concentrated in cities. Only 10 percent of the nation's doctors practice in rural areas, yet 25 percent of the U.S. population resides there. With Medicaid expanding in 26 states, and because rural populations tend to be poorer, rural Americans particularly will have difficulty accessing care. The Department of Health and Human Services projects that 7,987 primary care doctors will be needed in rural areas.
  • With the new regulations, doctors and hospitals are going to have difficulty breaking even. Hospitals already laid off 6,000 workers in 2012.
  • The ACA will add to physician dissatisfaction, which directly impacts quality of care. Almost 60 percent of doctors would not recommend medicine as a career, and 49 percent intend to stop practicing as soon as possible or reduce the number of years they spend practicing.
  • Because of increased regulation and costs, many independent doctors are selling their practices and joining hospital payrolls. By 2011, already half of U.S. doctors were working for hospitals, insurers or corporations rather than in private practice. This shift increases operating costs and raises prices for health care consumers.

Source: Amy Anderson, "The Impact of the Affordable Care Act on the Health Care Workforce," Heritage Foundation, March 18, 2014.

 

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