It has NOT increased availability of "urgent care centers" here in Albuquerque. It has decreased the hours available from 24 a day to just 9 or 10. That is a decrease of over 50%. So please do not spout your liberal propaganda to me.
https://docutap.com/blog/trends-to-watch-in-urgent-care-in-2016
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As for the ACA and Urgent Care, it's just a fact that the increase in insured patients - especially in states that expanded Medicaid - has created significant additional demand for immediate access treatment options, and that it's a major driver of the rapid ongoing expansion of such services.
http://aaucm.org/news/newsdetail.aspx?mobi=0&a=9130
In most areas local networks are all aggressively recruiting ACA patients for UCC visits, for example both UUCs and ACA acceptance is at the top of the home page for my provider network:
http://www.northshore.org/
And UCCs are increasingly niched right into networks, the reception desk at my PCP's practice has a handout listing the hours of the networks UCCs - they are an explicit, intermediate option between a scheduled visit to the practice and an ER level emergency.
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You have got me wrong: I'm in favor of competitive market solutions, I think that people ought to have a wide range of options and that competition improves the options available.
But the costs of the current system are just out of control.
And that's causing politicians - virtually all politicians - to promise two completely contradictory things: that their policies will allow us to retain some of the the worst aspects of our current fabulously expensive and inefficient system (or, often, an idealized version of the system circa 1980) and that their policies will structure things so as to provide most Americans with affordable health case.
And you just cannot do both of those things.
In the meantime, while the politicians on both the left and right argue about unrealistic and impractical "reforms", market forces are creating seismic level changes throughout the industry, of which the greatest is rapid concentration of provider networks into a few major players (or less) within each market.
And this in turn is what's gong to drive the actual form of health insurance - far more than political opinion.
For example, take the idea that selling insurance across state lines will lead to increased competition and lower prices.
The problem with this is that you can't just open a sales office (or put up a web page) in a new market and sell insurance - even if you are already doing so successfully in some other market.
Because you have to have something to sell.
And that something is a complex provider network - which you will now attempt to assemble in competition with existing networks.
It's a chicken or an egg problem: you can't afford to assemble a network unless you can attract plan participants, and you can't attract participants until you assemble a network.
And in the meantime, you are competing with existing plans which are already enjoying the economies of scale of being an existing network.
So this is where we are going to end up in a decade or so: in most markets most health care will be provided by a handful of highly integrated provider networks.
Does not matter if your insurance is via employment, subsidized private insurance, traditional or premium support Medicare, Medicaid or you pay for it out of pocket; most Americans will be receiving care via a privately owned vertically integrated provider network.
And once you start dealing with the political power of those behemoths, that, far more than ideology, determines what the US systems looks like.