As most of us gear up to ring out 2014 and welcome 2015, there’s a silent near-crisis that’s threatening the Medicaid program. In just days, there are deep cuts slated in the form of payments to physicians. Not surprisingly, concerns are that even more doctors will opt out of providing care for Medicaid recipients. This means, of course, it will become difficult for those with Medicaid to find the medical care they need.
The Obamacare Influence
When the Obama Administration was doing its best to drum support for its lukewarm Affordable Care Act, it promised big increases for those providing primary care for a period of time. That was in 2012 and the “period of time” was just for two years; come January 1st, those perks expire. Meanwhile, as the Supreme Court continues to hear arguments over many of the troubled health care law’s rules, the Obama Administration says doctors and other providers have no legal right to challenge the adequacy of payments they received from Medicaid.
The White House says Medicaid is contributing to the “largest coverage gains in four decades,” with 9.7 million people added to the Medicaid rolls since October 2013, bringing the total to 68.5 million. More than one-fifth of Americans are now covered by Medicaid. That’s massive – and is also indicative of the widespread problems these cuts will surely create.
Meanwhile, some doctors say they’ve been dealt the “bait and switch” move and insist the government lied when it enticed physicians into Medicaid with higher rates, only to lower reimbursement once the doctors come on board.
Were Some States Smarter than Others?
Several states opted to not expand Medicaid – most of which are in the south. It’s not likely to affect those consumers and medical systems; however, the Urban Institute reports doctors can expect to see a whopping 43 percent cut in their payments – with some states going as high as 50 percent. That includes Florida, California, New York, Pennsylvania and more. This has long term implications that could see a massive shift in the way healthcare is delivered.
The president, anticipating exactly what’s playing out today, proposed an extension earlier this year, which went nowhere. Not only that, but Republicans are gearing up to take control of both houses. This is bound to be a heated reality in a matter of weeks: physicians bailing, Medicaid patients unable to find care and Republicans enjoying every moment.
The reality is that the Medicaid rosters are growing fast, again, partly because of the new healthcare laws. Baby boomers are also continuing to retire, which another reality the government must accept and deal with.
Because many of our clients rely on Medicaid, our legal advocates continue to monitor the goings-on. Our goal is to always be current with these changes so that we can best represent our clients. If you’re concerned about your own Medicaid coverage or if you want to appeal a denial from Medicaid, we invite you to contact us today. The sooner we put the wheels in motion, the sooner you can move forward with confidence and the knowledge that you have someone on your side.