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    Expanded insurance access: Its effect on physicians

    That flood of patients experts predicted following healthcare insurance expansion under the Affordable Care Act (ACA)? Even though it’s been almost two years since the creation of federal and state healthcare exchanges, plus the expansion of Medicaid eligibility in some states, the expected access crisis has yet to be seen.

    But while numerous studies confirm that practices are for the most part keeping up with demand, the ACA’s impact on primary care physicians and patients has still been profound.

     “Quite honestly it’s kind of a relief to me to have more patients who are insured,” says Robert Wergin, MD, board chairman of the American Association of Family Physicians (AAFP.) As a practicing physician in a rural community of 2,000, Wergin is intimately aware of the hardships many of his patients faced in obtaining healthcare prior to the availability of the exchanges and their accompanying subsidies (Medicaid has not expanded in Wergin’s home state of Nebraska).

    He cites one patient in particular, a self-employed polio survivor with a multitude of chronic conditions, including scoliosis, muscle weakness, and lung problems related to his childhood disease. Prior to becoming eligible for a subsidy under the ACA, this patient paid more than $1,000 per month for health insurance, and fretted annually whether he’d be able to continue to afford it while running his photography business.

    “He always refused to go on disability,” Wergin says, even though he would have qualified easily. Qualifying for a health insurance subsidy, however, dramatically changed the circumstances for both the patient and his doctor. 

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