Those on Medicare may become the new "uninsured" ... if doctors don't participate, which could be a problem if the reimbursements are reduced.

Don't think doctors will opt out?
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Then what happens when the Fed decides they have to apply similar reimbursement limits to those in a Fed insurance exchange? You've got insurance. Terrific! But you can't find a doctor who will accept the plan you have since the reimbursement limits are too low.

If everyone has to go back to paying cash, then what? Or does the govt exert some kind of force to compel doctors to participate? How do they do that?

Also true that today those reimbursement limits are set by insurance companies. Obviously, they have been sufficient to keep doctors willing to accept the reimbursements and keep the doctors participating.

Oh, yeah ... IRS says it will not treat these no-insurance penalties like audits. They will simply match up the submissions from insurance companies to tax returns and send a nice letter to the taxpayer ... and deduct the tax from any refund that might be due.