Under Obamacare, you may have a right to get health care, but with increasing numbers of physicians not taking new Medicaid patients, good luck finding a doctor if you happen to be a low-income patient.
A recent survey of the medical profession found that fewer than half, 45.7 percent of physicians surveyed, are willing to accept new Medicaid patients, notes Joshua de Gastyne, a member of the Young Leaders Program at the Heritage Foundation.
The survey, by the physician search and consulting firm Merritt Hawkins, found the overall rate of acceptance of Medicaid as a form of payment in five medical specialties across 15 metro markets is 45.7 percent. Boston was the highest, at 73 percent, and Dallas the lowest, at 23 percent.
Medicaid patients and patients with private insurance often seek “convenient care” in hospital emergency departments when they cannot access office-based physicians in a timely manner, the study found.
The problem of physician access could become more pronounced as millions of previously uninsured patients obtain coverage through the Affordable Care Act, said Mark Smith, president of Merritt Hawkins.
In April, the Congressional Budget Office estimated 7 million people will be added to the Medicaid program this year.
“By further expanding this broken program (Medicaid), Obamacare will only exacerbate the situation, continuing to harm many low-income Americans who have no option other than Medicaid,” he said.
More standing in line
Phillip Miller, vice president for communications for Merritt Hawkins, in Irving, Texas, confirmed to WND that low-income people on Medicaid will do “a lot more standing in line to get medical care.”
“Low-income people are going to end up being pushed more and more into hospital emergency rooms for more accessible care, and they will go to community health care services that treat indigent populations,” he said. “But mostly, it’s going to be standing in line a lot more to get medical care.”
Miller contends that the way medical care is delivered to indigent, or impoverished, people will have to change.
“We need to utilize more widely non-physician health care providers to include more physician assistants, nurse practitioners and other types of clinicians who can do some of the types of things that doctors do,” he said.
The long-term solution, he said, is training more doctors and improving the economy.
“We have a shortage (of doctors),” he said. “And really it ties into the broader issue of economic opportunity. We have to improve the economy and get more people jobs so that they have the money to afford health care.”
Miller acknowledged that health care is “rationed one way or another, and increasingly it is going to be rationed by accessibility to health care services, including the physical ability to see a doctor.”
“Many doctors can only sustain so many Medicaid patients, because those patients are less well-paying, and a physician, at least in a traditional private practice, has to make some money to keep the doors open,” he said.
“So, physicians in private practice can only see so many indigent and uninsured patients. It will definitely be a challenge.”
Robert Moffit, senior fellow for health policy studies at the Heritage Foundation, said the Merritt Hawkins study is the latest report in a series of studies that have shown fewer physicians are willing to accept Medicaid patients.
“Medicare may give you the right to health care, but it doesn’t mean you can find a doctor,” he said.
Moffit noted that along with the problem of increasingly crowded emergency rooms, the medical profession “has become disenchanted with the Medicaid program, because Medicaid has very low reimbursements, even compared to Medicare, and much more red tape.”
He explained that Medicaid is actually 50 different programs that are jointly financed by the federal government and the state government. Each state administrates its own version of Medicaid, complicating administration of the program on a nationwide basis.
Moffit pointed out that Medicaid reimbursements are much lower than private health insurance and routinely lower than Medicare.
Another problem is that while providing much higher reimbursement, private plans also require much less red tape.
“The people who don’t have access to a doctor because they can’t find a doctor who’s going to take Medicaid reimbursement, may end up in medical clinics, if they are lucky,” he said. ‘But the clinics may not take them, because every time a Medicaid patient walks into a clinic door, the clinic loses money.”
He concluded Medicaid is no longer a reliable insurance option for low-income people, “especially for people who are sick.”
“If you are ill, especially if you have a chronic disease, you need consistent access to a physician who can monitor your condition,” he noted.
Moffit said the Medicaid expansion that is being engineered through Obamacare is “counterproductive national policy, because it does undercut access to physicians for the indigent.”
“Expansion of Medicaid does not mean expansion of access to medical care,” he said.