More Than a Quarter of Ohio Doctors Reject New Medicaid Patients

Only 72 percent of Ohio’s office-based physicians accepted new Medicaid patients in 2011, a Health Policy Institute of Ohio (HPIO) report released this month noted. Many doctors reject Medicaid because the entitlement program limits costs by underpaying care providers.

The HPIO report also explained that President Obama’s Patient Protection and Affordable Care Act (PPACA) “provides a fully federally-funded Medicaid payment rate increase for primary care services to 100% of Medicare payment levels in 2013 and 2014” as a way to “encourage greater physician participation in Medicaid.”

Medicare reimbursement rates, which are greater than Medicaid reimbursement rates, are still less than what private insurance pays for the same care. HPIO made clear that the PPACA rate increase will be very short-lived, writing that states “have the option to continue the rate increase beyond 2014 with state funds.”

In other words, although PPACA was written to coax more doctors into accepting Medicaid patients by paying doctors more to treat Medicaid patients, after 2014 Medicaid will resume paying at rates which have led 28 percent of Ohio doctors to reject new patients covered by the program.

Additionally, the HPIO “Ohio Medicaid Basics 2013” report mentioned that while some studies have indicated positive Medicaid outcomes, other studies have shown “that patients on Medicaid fare worse than those with private insurance and, in some cases, worse than those with no insurance.”

Governor John Kasich, a Republican, seeks to add hundreds of thousands of Ohioans to the Medicaid rolls because another PPACA provision promises the federal government will pay states for expanding Medicaid eligibility – and because a January HPIO study estimated Ohio could benefit in the short term from an influx of federal deficit spending.

As the Ohio General Assembly considers whether to implement the PPACA Medicaid expansion, news reporters across the state have repeated Kasich’s Medicaid expansion talking points without question. This has included frequent citations of the deeply flawed January HPIO study, because its economically outrageous assumptions are central to the Kasich administration’s Medicaid expansion narrative.

Yet somehow, HPIO’s recent acknowledgment that Ohioans with Medicaid coverage are already rejected by more than 1 in 4 of the state’s office-based physicians is not news. A LexisNexis search returned no mention of the HPIO study in The Columbus Dispatch, Cleveland Plain Dealer, Cincinnati Enquirer, Akron Beacon Journal, Toledo Blade, or Dayton Daily News.

Readers may wonder what purpose Ohio newspapers serve, if an issue affecting billions of dollars per year in public spending is covered exactly the same in the Dispatch, Plain Dealer, and Beacon Journal as in Governor Kasich’s press releases.

Even if the federal government was not $16.7 trillion in debt, a reputedly free market conservative like Governor Kasich would no doubt comprehend that promising a service and providing a service are two different things. However, Kasich has adopted progressive rhetoric to promote the PPACA Medicaid expansion; the January HPIO study served this purpose, and the March HPIO study affirming major problems with Medicaid did not.

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