BUTLER TWP — When asked why the Affordable Care Act, commonly referred to as ObamaCare and disliked by many doctors, was supported by the American Medical Association, Mike Fraser, executive vice president of the Pennsylvania Medical Society, had a simple answer.

“I don’t think anybody (at the AMA) read the bill,” he said.

Fraser spoke Thursday to address physician concerns about the ACA at a meeting of the Butler County Medical Society at Butler Memorial Hospital.

Fraser said the law has some good elements, but said it does not seem like doctors were involved in writing the law and many doctors are worried about unintended consequences.

He said the law is making physicians uncertain if they can afford to keep their practices, which could lead to increased consolidation. He also said the law has caused physician reimbursements to decrease.

The law is causing a change from a fee for service model, where physicians are paid based on the amount of care given, to a pay for performance model, where physicians are paid for meeting performance standards.

“The Affordable Care Act has changed the physician/insurer relationship,” Fraser said.

The law also has caused co-pays for plans to increase. He said if a patient does not cover his premium for one month under the law, the insurance company pays it. However, the care provider would have to pay if the patient cannot pay for the next 60 days.

Additionally, doctors are concerned about new penalties doctors face for not complying with the act, such as penalties for not participating in quality reporting.

Since the state has not had a full rollout of the policy yet, doctors cannot know what patient demand is yet, Fraser said. He noted that Massachusetts care providers saw long lines of patients waiting for care.

Several doctors in attendance told Fraser anecdotes about patients dropping out of their practices because the practices cannot meet the demands of coverage. In other cases, patients find that their co-pays of up to $70 are too high for them to afford treatment.

“It’s unaffordable for so many folks,” Fraser said.

Although doctors were told they could opt out of ACA insurance plans, many insurance companies have told doctors that they cannot by law. Fraser said it is not a law.

“It’s a business practice,” Fraser said.

He said that doctors could lobby to try to outlaw such business practices.

Although the Pennsylvania Medical Society has not taken a position on the law, he said that physicians need to tell legislators how they feel about the law.

“This is impacting patient care,” Fraser said. “That’s compelling.”