Obamacare supporters have boasted about an uptick in Medicaid enrollments, but does the program offer much more than an insurance card?
Health-care consulting firm Merritt Hawkins conducted a survey of Medicaid acceptance rates which found that just 45.7 percent of physicians are now accepting Medicaid patients in the U.S.’s largest 15 cities. The federal welfare program cuts costs by reimbursing physicians at extremely low rates, preventing many doctors from seeing patients with Medicaid coverage.
The report considered care in 15 cities and across five specialties, and also cataloged wait times to access physicians given any insurance plan across the spectrum using 2013 data, pre-Obamacare reforms. This year will see a surge of Medicaid patients with fewer available doctors.
The report suggests that those Americans will still struggle to actually get health care once Obamacare and Medicaid expansion coverage is instated. Merritt Hawkins concluded that “access to health insurance does not always guarantee access to a physician…many if not most physicians in the 15 markets examined are not accepting Medicaid as a form of payment.”
This follows a growing body of evidence that Medicaid patients don’t fare much better than those without insurance at all. Studies of Oregon’s unique Medicaid lottery program have repeatedly concluded that Medicaid doesn’t improve health outcomes.
Given limited funds to expand the state Medicaid program in 2008, Oregon officials instituted a lottery to decide who would receive coverage. Long term studies of the health care consumption and health outcomes of those that received Medicaid coverage and those that remained uninsured found little difference.
In May 2013, experts studying that system frankly concluded that Medicaid “generated no significant improvement in measured physical health outcomes.” An updated report on the program in January found that those with Medicaid frequented emergency rooms at a higher rate than the uninsured, as a form of catch-all health care possibly because the coverage provides so little access to physicians themselves. (RELATED: Harvard study: Medicaid actually increases ER visits)
And Oregon’s Medicaid program pays physicians better than most of the country, according to Forbes. Medicaid pays Oregon primary care physicians around 62 percent of what private insurers would pay for the same services; the national average is 52 percent.
Boston’s experience could be a harbinger for Obamacare outcomes as well. In the capital city of Massachusetts, whose Obamacare-like health care program has been in place since 2006, patients had to wait the longest to see a physician after attempting to get an appointment.
“Long appointment wait times in Boston could be a precursor of what is to come nationally should some 25 million people or more eventually obtain insurance through the ACA,” the study noted.
Current Obamacare enrollment is nowhere near that rate, but areas already suffering from physician shortages could experience longer wait times as well. Three million Americans have selected a private plan on insurance exchanges and another 6 million have either opted for the Medicaid expansion or signed up or renewed standard Medicaid coverage for 2014.
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