An increasing shortage of primary care physicians will only increase wait-times for scheduling an appointment, regardless of increased insurance coverage. The current trend towards younger and healthier people opting out of mandatory coverage by simply paying a fine, rather than the premium, may portend a continuing problem of the uninsured, hence overutilization of ED's. For any individual, ED treatment is guaranteed under the federal EMTALA law. Teleprimary care may significantly reduce routine ED visits, a chronic and costly problem affecting healthcare today.

The current trend towards younger and healthier people opting out of mandatory coverage, simply paying the fine, rather than the premium portends a continuing problem of the uninsured – hence overutilization of EDs.

Finally, for those accustomed to immediate care via the ED where they are guaranteed of seeing an MD under federal EMTALA law, we simply do not know what any population of newly insured patients is going to do with improved access to routine acute and chronic outpatient care.