The new health reform law is expected to create 32 million more insured Americans, according to the Congressional Budget Office. The federal government plans to expand Medicaid to low-income adults and subsidize purchases on the health insurance exchanges when it requires most Americans to carry insurance in 2014. However, an insurance card will not mean much to patients without providers to care for them. Wisconsin will have 326,000 more insured residents because of reform, according to an Urban Institute analysis.