“The artificial cap on the number of funded graduate medical education positions limits final training opportunities for physicians and thus limits access to care,” writes Marc B. Hahn, president and chief executive officer of the Kansas City University of Medicine and Biosciences. “This compounds the current primary care physician shortage and has the potential to be the single greatest barrier to accessing quality health care.”

If you favor accessible health care and the Affordable Care Act, it’s too soon to panic over a federal appeals court ruling that would knock out subsidies for roughly 5 million people enrolled in the federally created online insurance exchanges. But worry? Oh yes. Worrying would be in order right now.