The GOP’s plan to repeal and replace Obamacare is premised, in part, on the idea that Medicaid fails to serve its enrollees with adequate access to doctors. But Medicaid recipients feel otherwise, according to a Centers for Medicare and Medicaid Services analysis.
While numerous studies have found that Medicaid increases access to care, not a lot of them have focused on how satisfied Medicaid patients are with the care they receive, according to a press release on the new report. It turns out those patients are pretty happy with it.
The CMS analyzed patient data collected from December 2014 to July 2015 and found that Medicaid enrollees rated their overall health care at 7.9 on a scale of zero to 10, with 10 being the best care possible. Forty-six percent gave their Medicaid coverage a score of 9 or 10, while only 7.6 percent gave scores under 5. Ratings were similar in Medicaid expansion and non-expansion states.
In terms of physician access, 84 percent of the enrollees said they hadn’t had a problem getting all the care that they or their physician believed was necessary in the past six months, and 83 percent reported having a regular source of care. The mean percentage of beneficiaries able to get all needed care was slightly higher in Medicaid expansion states than in non-expansion states (85.2 percent versus 81.5 percent). Just 3 percent of enrollees reported not being able to get care because of long waiting times or physicians not accepting their insurance. Two percent reported lacking a usual source of care because “no doctors take my insurance.”
“We found that Medicaid enrollees are generally satisfied with their coverage across multiple demographic groups and state expansion choices,” wrote the authors, Drs. Michael Barnett and Benjamin Sommers. “We also found little evidence that low physician participation rates are a key barrier to care for most Medicaid enrollees, consistent with prior studies of access to care in Medicaid.″
The doctor participation rate in Medicaid has been a key argument used by those who want to roll back the program. Health and Human Services Secretary Tom Price has claimed that “one out of every three physicians in this nation aren’t seeing Medicaid patients.” House Speaker Paul Ryan (R-Wis.) said “more and more doctors just won’t take Medicaid.” The implication is that Medicaid patients cannot access care, a situation that has worsened since the Affordable Care Act expanded the health care program for the low-income and disabled.
But experts have said that isn’t universally true. The participation rate varies by state, and it’s largely tied to reimbursement rates. For example, Montana pays primary care doctors the same rate for Medicaid and Medicare, and has a Medicaid doctor participation rate of 90 percent.
The most recent figures from the Centers for Disease Control and Prevention’s National Center for Health Statistics are for 2013, showing the percentage of physicians accepting new Medicaid patients was 68.9 percent, while 84.7 percent accepted new privately insured patients and 83.7 percent accepted new Medicare patients. That’s based on a national survey of more than 4,000 office-based physicians.