Will Any Medicaid Patient Be Able to See a Doctor in January?

The next Obamacare shoe is about to drop, making it even more difficult for Medicaid patients to find a doctor who will treat them.
 
Under the Affordable Care Act, primary care doctors seeing Medicaid patients got a two-year bump in reimbursement rates, up to Medicare levels—which is still, on average, about 80 percent of what private insurance pays.
 
That increase ends December 31, which means that come January doctors treating Medicaid patients will be making a lot less. How much less?  It depends on the state, because states have had different reimbursement levels.
 
The Urban Institute just released a report estimating the decrease by state; it’s not a pretty picture. Across all states, Urban estimates a 42.8 percent reduction in primary care fees for eligible physicians in 2015.
 
But Urban breaks the analysis down in various groups. It estimates that doctors in the 27 states that expanded Medicaid under Obamacare will see a 46.2 percent reduction, while primary care doctors in states that did not expand Medicaid will face a 36.8 percent reduction.
 
The biggest estimated drops are: Rhode Island (67.3%), Michigan (58%), New York (55.3%), New Jersey (52.9%) and Florida (52.5%).
 
Doctors are increasingly refusing to take new, and in some cases any, Medicaid patients. The Physicians Foundation’s “2014 Survey of America’s Physicians” reports that 38 percent of physicians either do not see Medicaid patients or limit the number they see. Generally speaking, primary care doctors have been more willing than specialists to continue taking Medicaid patients.
 
Do you think a 40 percent or 50 percent reduction in primary care reimbursement rates just might have an impact on whether those doctors “just say no” to Medicaid?
 
These developments leave the Democrats, and especially President Obama, in a difficult position. One of their stated goals in ramming through Obamacare was to give the poor increased access to health care. If the poor cannot find a doctor who will treat them, Obamacare will have failed—yet again.
 
Of course, conservatives and Republicans repeatedly warned that expanding insurance coverage was not the same as expanding access to care. Democrats completely dismissed those warnings.
 
Some states have decided to extend the current reimbursement levels through 2015, using only state money.
 
But when the Medicaid reimbursement disappears, starting next month for most states, there may be growing outcry to fix Medicaid—and Obamacare.