The number of doctors willing to see Medicaid patients has been in decline for quite a while, due primarily to the low reimbursement rates the program offers. One of the few things in Obamacare that demonstrated an actual understanding of economics (which is not the same as saying it was good policy) was the inclusion of funding to raise fees paid to primary care physicians who see Medicaid patients.
Not surprisingly, the Obama administration managed to bungle even this. Rules and regulations implementing the higher fees, which were supposed to be available from January 1 of 2013 until December 31 of 2014, weren’t set until mid-2013. And a temporary fix is just that, temporary (and the “fix” part is in doubt as well, at least in this case), meaning the problem isn’t really solved, just put off until another day.
It’s likely Democrats in Congress only authorized the Medicaid fee increase for 2 years in order to keep the overall cost of Obamacare down under Congressional Budget Office rules, assuming they would stay in the majority and would simply extend the fee increase when it expired.
As you may have noticed, there is no Democratic majority in Congress at the moment to extend the fee increase.
So, on January 1, 2015, Medicaid’s fees will plunge in many states (some states are funding extensions on their own), about 47 percent on average according to this Urban Institute study: Reversing the Medicaid Fee Bump: How Much Could Medicaid Physician Fees for Primary Care Fall in 2015?
Needless to say, this is going to mean a lot of people on Medicaid aren’t going to be able to get in to see a primary care physician, and the current one-third of physicians who aren’t accepting Medicaid patients is sure to grow.
I’m sure some will say this just means it’s more important to elect the “right” people to office so they can enact policies like extending the increased Medicaid fees. A plausible takeaway, I suppose.
An alternate lesson, I propose, is that this is a pretty good example of why we shouldn’t be handing over important things like health care to politicians of either party, because eventually you’re going to see the “wrong” people are in office and they don’t share your beliefs on how or even whether government should be providing that important thing.