Twenty million, four hundred thousand. That’s a big number. According to the most recent data from the Department of Health and Human Services’ (HHS) National Center for Health Statistics, that is how many more Americans have health insurance coverage than in 2010, when the Affordable Care Act (ACA) was enacted.

For America’s physicians, 20.4 million is not just an abstract figure. It represents their patients—living with illness or working to prevent it—who now have health insurance coverage to support their care. And as the nation’s elected representatives consider changes to the health system, it is a number no one wants to see go in the wrong direction.

My lede. The whole shebang.