Many Americans trumpeted the millions of uninsured who obtained health coverage in 2014 via Medicaid or Obamacare exchange coverage. However, the Affordable Care Act made assumptions that all states would expand Medicaid coverage and this simply has not happened. In fact, 23 states have opted not to expand Medicaid leaving healthcare providers to face even more high uncompensated care costs.
Rubbing salt in the wound, Congress failed to extend Medicaid rate increase for primary care services before they adjourned at the end of 2014. The Affordable Care Act sought to increase Medicaid payments on par with Medicare. The thought process was that this would incentivize more physicians to see this newly expanded pool of Medicaid patients.
An analysis performed by the Urban Institute shows an average 2015 Medicaid reduction of 42.8%, with physicians in California, Florida, and New York being cut more than 50%. The Kaiser Family Foundation claims that 15 states are trying to find ways to cover some of the costs (in an attempt to keep Medicaid on par with Medicare). However, with many states already in a tight budget stance, it remains to be seen if and to what extent this will come to fruition.
So, now that the temporary two year hike in Medicaid rates has come to an end in at least half of the country, we may see a reverting of physicians opting to not accept Medicaid patients. With more patients now on Medicaid as a result of Obamacare, that would mean a larger number of patients having trouble getting access to healthcare than before the law was passed.
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