When the aca was passed, insurance was mandatory.
Sorry i forgot that the gop tax bill in 2017 repealed the individual mandate penalty.
Some states still do have a penalty for being uninsured.
I don't understand this meme.
If you have an hmo you're supposed to have a primary care doctor/physician.
If you have ppo then sure, it would make no sense to have a primary care since its not required to see a specialist.
But if you have insurance and your not well off then it a pcp isnt an issue or you have an hmo.