Medicaid Coverage Does Not Equal Access to Care

Last week I posted an article discussing the shortage of doctors treating Medicaid patients in NC and how that would undermine claims that expanding Medicaid would create jobs.

Medicaid rolls in North Carolina have ballooned from about 1 million in 2003 to roughly 1.7 million today. Adding another 500,000 would push the program over 2 million enrollees and mark more than a million new Medicaid patients in a dozen years.

All this would take place when the number of physicians accepting Medicaid patients is dwindling.

Imagine adding since 2003 the equivalent of the entire population of Wake County to a group of people fighting over a shrinking pool of doctors.

In short, if Medicaid patients can’t see a doctor, there is no service provided. With no service provided, no federal dollars are “drawn down” to the state to healthcare providers. Without the money, no jobs. (NOTE: even if NC did have the supply capacity, job creation claims for Medicaid expansion would be wrong)

This Charlotte Observer article helps shed further light on the problem I pointed out.

The new year brings two new challenges for North Carolina doctors who take Medicaid, as a temporary boost from the Affordable Care Act goes away and a state cut kicks in after a year’s delay.

Hardest hit will be the family practitioners and pediatricians who are supposed to take the lead in providing better medical care for about 1.7 million low-income children and adults in North Carolina. Those doctors could see payments drop by more than 20 percent this year as the ACA bump from 2014 ends, according to a study by the Washington-based Urban Institute, which researches issues related to poverty.

….

But one challenge, in North Carolina and across the country, is a shortage of primary care doctors. North Carolina has less than half the number of doctors needed, according to a 2014 survey by the Kaiser Family Foundation, a health care research group.