"All the places where people get primary care in this community will be strained by millions more people with a health insurance card than formerly had coverage, so, we’re all as a community going to have to respond,” said Dr. William Faber, RGHS Executive Medical Director.

Even before President Barack Obama's health care Act was upheld by the Supreme Court, local health care providers say they were facing a shortage of primary care physicians.

Faber says about 20 percent of the region's existing primary care network is expected to retire over the next 10 years, and recruiting isn't easy.

"We’re at the low end of the reimbursement scale,” Faber said. “And of course, if you’ve got a $200,000 debt, the first thing you want to do is go into the most lucrative field you can to repay that. Well, our country doesn’t directly subsidize primary education."

"One of the key policy questions for us going forward, is the funding for graduate medical education, which is the mechanism by which we fund the residency training programs, that produce the doctors, that actually serve this community," said Peter Robinson, URMC Chief Operating Officer.

In addition to program funding, the University of Rochester Medical Center plans to lobby The Centers for Medicare & Medicaid Services to increase the cap on the total number of students that it can admit to its primary care programs.

Local health care providers say without incentives, it will be difficult to achieve the intended benefits of the Patient Protection and Affordable Care Act.

Without adequate primary care, they say patients will continue to crowd emergency rooms and require procedures for health care issues that might have been avoided.

"We can’t continue to afford the inflation rate of health care in the United States. It’s really hurting us financially as a country and so that’s why I keep saying it’s a good investment to subsidize and support primary care expansion, because over all it will have the best impact on our national debt."