Phase 2: Wave 1: seniors, near-seniors, and children · Step 2.6

Expand capacity before demand peaks

Year 0 onward; continuous · HRSA; UHA; states (scope of practice)Discuss this step

capacitylikelihood: highimpact: severe

Wait times rise and the employer-insured revolt

Demand rises immediately while training new clinicians takes years. The previously commercially insured, the largest and most politically active group, notice longer waits and turn against the program before capacity catches up.

Early warning signs

Registry shows specialty waits above guarantee in 3+ regions
Rising voucher payments
Physician opt-out above 5% in any specialty

Mitigation

Age-phased enrollment
Wait-time guarantee vouchers
Capacity capital in Years 0–5
Scope-of-practice expansion
Rates above Medicare

Implementation risks

Risk	Mitigation
Demand surge in Years 1–4 outpaces capacity growth.	Phase-in by age spreads the surge; telehealth; triage; the wait-time guarantee.