Expansion of Medicaid in California Could Lead to Shortage of Doctors
The number of Medi-Cal patients has grown sharply, thanks to Obamacare, but the number of doctors willing to see them has not. In fact, the number of doctors in California willing to take Medi-Cal patients could drop once planned cuts to reimbursement rates kick in next year.
California now has ten million low-income Medi-Cal recipients. Those who signed up under expanded Medicaid as part of Obamacare will have their coverage paid for by the federal government. However, having money to pay doesn't mean there are any more doctors available to accept payment.
Dr. Del Morris described a scene which he fears could be the future of California's Medi-Cal program. He told the Contra Costa Times that as flu season peaked in January, Medi-Cal patients jammed emergency rooms to such an extent that ambulances were unable to unload their patients. That meant the EMTs couldn't respond to subsequent emergency calls. Having coverage did not equate to getting care.
And the situation may be about to get even worse. The federal government offered to pay general practitioners who would see the new Medicaid patients at higher Medicare reimbursement rates for the first year. But those rates will drop sharply next year.
Dr. Esteban Lovato is a longtime supporter of the Medi-Cal program. He told the Times that he currently gets about $42 to see each Medi-Cal patient. But next year when rates revert to Medi-Cal rates, including a ten percent cut included in next year's budget, his reimbursement per patient could drop to $21. That would make it very difficult for him to continue to take Medi-Cal patients. It would also ensure that his colleagues in the medical profession would be less likely to start seeing them.
There's another problem connected to the new Medi-Cal enrollees. The push to enroll people in Obamacare also brought hundreds of thousands of people who were previously eligible out of the woodwork. But unlike expanded Medicaid where the federal government pays the cost, in the case of people who were previously eligible, the state pays half the cost of their coverage. Governor Jerry Brown just added $1.2 billion to next year's budget to cover the costs of the additional 800,000 Medi-Cal recipients who fall into this category.
Either there will be backlogs of patients unable to make appointments because there are not enough doctors to see them, or the state will be forced to increase the amount doctors are reimbursed. In the former case, the patients will experience delayed care. In the latter, the taxpayers will be asked to come up with billions more to cover the cost.