Changes in Medicaid May Affect Your Ability to Get A Doctor Appointment

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Changes in Medicaid May Affect Your Ability to Get A Doctor Appointment

Medicaid payments to States were reduced recently, possibly affecting access to care for people using the insurance program. The Affordable Care Act (“Obamacare”) helped States by providing an increase in Medicaid payments for primary care in 2013 and 2014,, but the increased funding expired several weeks ago. According to the New York Times, the impact of the changes varies by State, and the payments for primary care services in New York could drop as much as 50%.

The reduction in cuts could be particularly problematic, as enrollment in Medicaid is “surging.” More than one-fifth of Americans are now covered by Medicaid. NYT

The access to care issue arises because, now that Medicaid reimbursement rates are returned to their 2012 level, doctors may lose money by taking on new Medicaid patients. According to a quote from the CEO of “one the country’s largest Medicaid insurers” in USAToday, “The challenge is to persuade physicians not just to continue accepting such patients but to take on more without getting paid what they’re used to.” According to DisabilityScoop, there is evidence to support the idea that the higher reimbursement rates for primary care boosted access to care for low-income patients. This article describes a study conducted in 10 States, showed an average increase of 8 percentage points in access to care, measured by the number of primary care appointments for Medicaid patients.

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