As 2016 premiums rise when will the affordable" part begin?
By Dr. Merrill Matthews
Texas Insider Report: Dallas Texas The next Obamacare shoe is about to drop making it even more difficult for Medicaid patients to find a doctor who will treat them.
Here in January 
2015 doctors treating Medicaid patients will be making a lot less. How much less?
It depends on the state.
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 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 recently released
a report estimating the decrease by state; its not a pretty picture. Across all states Urban estimates a 42.8 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 reduction while primary care doctors in states that did not expand Medicaid will face a 36.8 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 Foundations
2014 Survey of Americas Physicians" reports that 38 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 or 50 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.
Dr. Merrill Matthews is a Resident Scholar at the Institute for Policy Innovation (IPI) in Dallas Texas. Follow him on Twitter @MerrillMatthews
