One of the more positive sections in the Affordable Care Act gave a temporary pay hike to the paltry amount primary care physicians were paid by Medicaid for evaluations and vaccine administration. Under the law, Medicaid fees for primary care increased in 2013 and 2014 to the same amount paid under Medicare. The raise was in hope that higher rates might entice more physicians to accept Medicaid as millions of more people were added to the coverage roles under the law.
Only twenty-seven states and Washington, DC, are actually participating in Medicaid expansion. The rest have opted out under the 2012 Supreme Court on the ACA. The Medicaid raise however still applies in all states regardless of their status and has helped physicians expand their capabilities.
Medicaid is jointly funded by federal and state governments, with Federal dollars providing the lion’s share. The federal money that makes the higher rates possible however is set to run out at the end of this year and according to an article in Kaiser Health News, only 6 states — Alabama, Colorado, Iowa, Maryland, Mississippi, and New Mexico intend to spend their own money to maintain the PCP rate increases. With the exception of Alaska and North Dakota who supported the raise on their own even before 2013, the physician in the remaining 42 states will see payments revert to the pre-2013 levels.
A bill, called the Ensuring Access to Primary Care for Women & Children Act, has be introduced in the Senate that is similar to what the Obama administration proposed in the budget but that one carried a $5.4 billion dollar price tag without a “pay for” provision.
Both Kaiser Health and Medscape are covering the issue in pretty good detail but it looks unlikely that any action will get through Congress any time soon.
How do you think this will affect Primary Care in the US?