A new study published August 6 in the journal Health Affairs found that 31 percent of doctors nationwide are not accepting new Medicaid patients, a figure significantly higher than the rate for Medicare providers, 17 percent, and private insurers, 18 percent.
This stark discrepancy highlights the particularly low rates that federal and state governments pay to doctors to reimburse them for their services to Medicaid patients. In New Jersey, the state with the nation’s lowest reimbursement rates, a mere 40 percent of doctors answered that they were accepting new Medicaid patients, according to an article by Kaiser Health News. In contrast, Wyoming, the state with the highest rates, 99 percent of doctors are accepting new Medicaid patients.
The rates are lowest in doctors who work in smaller practices or metropolitan areas.
As part of the Affordable Care Act, the federal government will pay an estimated $11 billion to states to raise payment rates by an average of 30 percent in 2013 and 2014, with New Jersey receiving as much as a 50 percent increase. However, many doctors and advocates are concerned that the payment rate increase is only for two years, and that Congress is just delaying creating a long-term fix. The rate only applies to primary care doctors, not specialists.
Although states are allowed to independently set their own payment rates, federal Medicaid law mandates that states provide high enough rates to ensure that there are enough providers so patients have meaningful access to health care, in what is known as the Equal Access provision.
Disability rights advocates have long been active in calling for higher Medicaid rates. Since 2008, Disability Rights California has successfully blocked repeated attempts by state legislators to cut payments rates.