It sounds like you live in a rural area. In those places, the providers are drying up as the doctors get old and retire, and there's no one to replace them. This has nothing to do with Obamacare; it's like this in many places, including here in Japan. They actually offer more money here for people to work in the medical field in rural areas, but people would rather get paid less to live in Tokyo, because no one with an education wants to live in rural areas these days if they don't have to.
Basically, if you want really good healthcare, you need to live in or near a very large city. (Albuquerque is not a very large city.)
Another thing that's probably changed in the US is larger healthcare companies taking over doctors' practices and enshittifying them to increase profits. Doctors are happy to sell because they're getting close to retirement, and/or tired of dealing with all the administrative hassle on top of actually being a doctor and caring for patients. I've read about this type of thing greatly affecting veterinary care in the US too.
Basically, if you want really good healthcare, you need to live in or near a very large city. (Albuquerque is not a very large city.)
Another thing that's probably changed in the US is larger healthcare companies taking over doctors' practices and enshittifying them to increase profits. Doctors are happy to sell because they're getting close to retirement, and/or tired of dealing with all the administrative hassle on top of actually being a doctor and caring for patients. I've read about this type of thing greatly affecting veterinary care in the US too.