Changes in Primary Care Physicians’ Patient Characteristics Under the ACA

January 11, 2018

The feet and legs of many people sitting in chair in the waiting room of a primary care physician.When the Affordable Care Act (ACA) passed in 2010, health analysts expressed concerns that the expansion in coverage, predominantly through Medicaid and the Health Insurance Marketplace would overload the health system and cause problems with access to care. Specifically, many feared the impact of coverage expansion on primary care doctors. Seven million Americans live in areas where demand for primary care may exceed supply by more than 10 percent. An estimated 20 million people have gained insurance coverage nationally since the ACA’s major coverage provisions went into effect in 2014, including more than 14 million in Medicaid and CHIP, as of March 2016.

In Michigan, insurance coverage increased from 89.0 percent in 2013 to 94.6 percent in 2016. A survey of Michigan primary care doctors shows that the fears of overwhelming the health system have largely not come true. This brief looks at what Michigan primary care physicians (PCP) say about the impact of the coverage expansion on their practices.

Key findings include:

  • The majority of PCPs reported an increase in the number of newly insured patients since healthcare coverage was expanded under the ACA. Many of the newly insured are Medicaid patients.
  • PCPs are now seeing more patients and sicker patients compared to before the ACA. However, most say their individual patients are not making more frequent office visits since the ACA took effect.
  • Most PCPs said their ability to deliver quality care had either stayed the same or improved since the advent of the ACA’s coverage expansion.