End of federal Medicaid boost will cut doctor's pay, may limit access

December 09, 2014

The ACA increased Medicaid fees for primary care doctors for 2013 and 2014, with the federal government paying the cost. That boost expires Jan. 1 and efforts to secure an extension from Congress appear thwarted by the political debate over Obamacare. A study from the Urban Institute estimated fee reductions will average about 40% nationwide, but they could reach 50% or more for primary care doctors in California, New York, New Jersey, and Illinois - big states that have expanded Medicaid under the health law. In Pennsylvania, where Medicaid expansion takes effect Jan. 1, doctors are facing a 52% fee reduction, according to the study. Doctors probably won't dump their current Medicaid patients, but they'll take a hard look at accepting new ones, according to the president of the American Academy of Family Physicians. Fifteen states are planning to use their own money to continue paying higher Medicaid fees through 2015. Among them are several Republican-led states that have resisted Obama's broader Medicaid expansion, including Mississippi and South Carolina. Another dozen or so states are undecided. Doctors groups say they will try to revive the Medicaid fee boost next year, when lawmakers must act to prevent a big cut in Medicare physician payments.
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