With the new year comes a new step for the Affordable Care Act: doctors who treat Medicaid patients will see a smaller paycheck. One of the key ways the health care law provided insurance to more people was by relaxing the restrictions on who can qualify for government-sponsored health care programs. Doctors get a pretty good reimbursement for treating patients on Medicare, like elderly Americans and people with disabilities, a little over $45 for a straightforward visit. In contrast, lower income people who receive Medicaid (or Medi-Cal in California), net doctors just $18 a visit.
Lawmakers were worried that doctors wouldn’t want to take Medi-Cal insurance, so they boosted the pay for doctors to smooth over the transition. That changes this year. An analysis by the Urban Institute finds that doctors will receive 58.8% less than last year for treating Medi-Cal patients.
The expansion of Medi-Cal has insured 2.2 million more Californians. With lower rates, many advocates are concerned that primary care physicians will stop seeing Medi-Cal patients. Meanwhile, physicians and patient advocates agree that the subsidy was so complicated, that many doctors didn’t succeed in receiving the better reimbursements for the two years they were available. Maintaining the subsidies -- which, like all Medicaid costs, are split between the state and federal governments -- would cost $1.8 billion per year.
What will health care access look like in California this year? And how will doctors react?
Guests:
Christopher Perrone, researcher at the California HealthCare Foundation who has studied Medi-Cal access
Dr. Richard Thorp, a primary care physician in Paradise, California (near Chico) and former president of the California Medical Association