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Medicaid Blues in a Red State

July 10, 2012
9:26 am

Governor Rick Perry’s announcement that Texas will not participate in the coming expansion of the Medicaid program – a decision made possible by last month’s Supreme Court decision forbidding the federal government to penalize states that opt out of Medicaid expansion – is extremely significant, but it’s probably not the most important Medicaid-related headline to come out of the Lone Star state this week.

Yesterday, the Texas Medical Association released new statistics showing a precipitous decline in the number of physicians accepting new Medicaid patients.  In 2000, two out of every three doctors were seeing new patients on Medicaid.  This year, that number has dropped to 31 percent.

That wasn’t the only worrisome aspect of the survey.  The report also found that 58 percent of Texas physicians said they are seeing new Medicare patients.  That number was 78 percent in 2000.

What these Texas figures show is that we have trend lines moving in opposite directions.  The intent of the Patient Protection and Affordable Care Act (PPACA) is to put millions more Americas on the Medicaid program.  And, at the same time, the retirement of the baby boom generation is moving over 7,000 citizens per day onto the Medicare rolls.  While the Medicare-Medicaid population is increasing rapidly, more physicians are refusing to see patients reliant on government health programs.

This problem was predictable.  As the head of the Texas Medical Association put it, “Every business has a breaking point, and physicians’ practices are no different.”  With Medicare and Medicaid payment rates significantly lower than private insurance reimbursements, it’s naïve to expect physicians to accept an altered patient mix with a significantly higher proportion of patients receiving government health coverage.

This is a question the next Congress (understanding that this issue won’t be resolved in the current election climate) will need to address.  With numerous governors not yet committing to Medicaid expansion and more physicians joining their Texas counterparts in not expecting new Medicaid patients, is there a better way to provide health coverage to low-income Americans?

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