Hours after the sweeping health care reform was signed into law Tuesday, experts downplayed worries that the newly insured would flood the limited number of primary care providers, forcing even more patients into already overburdened emergency rooms.
Gerald Kominski, associate director of the UCLA Center for Health Policy Research, said that when Medicare was enacted in 1966, the system wasn't overwhelmed.
He says that nationwide, the 32 million Americans with new health care coverage will translate into an approximately 8percent increase in office visits.
Studies have shown, Kominski said, that the uninsured are generally more healthy than the insured, a typically younger group where some have made a calculated gamble that because they are healthy, they won't need health insurance.
"If you had diabetes, you would do everything you could to get health care insurance," he said.
Greg Thorson, a political science and public policy professor at the University of Redlands, said that by insuring an additional 32million people, the government was opening up huge avenues for preventative medicine practices, which should keep many with chronic conditions from needing emergency room services.
Regular checkups are a far more
Gilbert said while emergency room utilization would go down, "it might not go down as much as some people would want it to go down."
Another aspect of the issue is Medi-Cal. Of the 800,000 newly insured people potentially coming into the Inland Empire system, about 200,000 will be Medi-Cal patients.
Dr. Bradley Gilbert, chief executive officer of the San Bernardino-based Inland Empire Health Plan, said more primary care physicians will be called upon to serve Medi-Cal patients because they will be paid at the higher Medicare rate.
The other 600,000 formerly uninsured individuals and small businesses will choose an insurance plan from a state-based health insurance exchange, he said.
Depending upon income, federal subsidies will help offset the cost of buying insurance, Gilbert said.
Don't worry about getting in to see the doctor anytime soon. The addition of these uninsured won't kick in until 2014.
The pay boost of about 30 percent for primary care physicians under Medi-Cal will take effect in 2013 - a year before the newly insured are folded in, said Marion Mulkey, a senior program officer for the California HealthCare Foundation, an independent philanthropy group based in Oakland.
Reimbursement rates for primary care physicians serving Medi-Cal patients will begin to climb starting next year, said Andrew LaMar, California Medical Association spokesman.
After 2014, it's unclear what will happen, LaMar said.
Because the rate increase only affects primary care physicians, access to specialists will continue to be a problem, Mulkey said.