By March 31, 2014, the Centers for Medicare & Medicaid Services (CMS) has projected 7 million Americans enrolled in the health insurance exchanges. There are numerous reports of how far behind estimations are.
According to a September letter to the House Ways and Means committee [PDF], by December 2013, the agency believed 3.3 million would have enrolled. The number is close to, 2 million. The technical glitches barring some from enrolling in the federal HIX surely is to blame for the shortfall; however, there are three more months to get to the 7 million mark.
Of that number, 2.7 million people aged 18−34 need to enroll to ensure an adequate risk pool. It's not clear if young people are signing up, as hoped, as expected, and most importantly, as needed.
The effect of the surge of newly insured patients seeking out care is expected to put a strain on physicians, who are already being squeezed out of some insurance networks or being asked to take reduced reimbursement for new patients.
And, if the SGR three-month patch is extended to yet another temporary fix to be dealt with after the 2014 mid-term elections, physician groups may not be able to back burner or recapture their optimism for a permanent repeal in 2015.
The impact of these wildcards on how physicians care for patients and are paid for their services can't be underestimated. During the next three months of intense healthcare transformation, expect some anxiety among physicians.