50% of Listed Medicaid Doctors Not Accessible


Remember all of the wonderful promises that Barack Obama and Nancy Pelosi made about the Affordable Care Act? One of those promises was that we would all have more access to better medical care than before. If you believed that whopper of a lie, then let me know as I have some land to sell you in downtown New York City.

Part of that bogus promise of more access to better care was linked to the expansion of Medicaid coverage. According to government reports (we all know how reliable they are, don’t we), an additional nine million people enrolled in Medicaid due to the expansion of who was covered. All of these new enrollees are offered their selection of plans under Medicaid and depending upon which plan they chose, they were then provided with a list of physicians who were covered under that plan.

Sounds simple enough, if that was all there was to it, but it’s turning out not to be so simple after all.

The inspector general of the Department of Health and Human Services investigated the availability of Medicaid listed physicians and what they found is more than troubling. They called 1,800 providers that were listed as Medicaid physicians in over 200 health plans in 32 states.

Perhaps the most glaring discovery was that a full third of all of the listed physicians they checked could not be found at the number or location given by the health plan. Another significant portion of listed Medicaid physicians said that they either no longer participated in Medicaid or they were not taking on any new Medicaid patients.

Daniel R. Levinson, Inspector General of DHHS explained:

“In these cases, callers were sometimes told that the practice had never heard of the provider, or that the provider had practiced at the location in the past but had retired or left the practice. Some providers had left months or even years before the time of the call.”

“When providers listed as participating in a plan cannot offer appointments, it may create a significant obstacle for an enrollee seeking care. Moreover, it raises questions about the adequacy of provider networks. It suggests that the actual size of provider networks may be considerably smaller than what is presented by Medicaid managed-care plans.”

Of the providers that did accept new Medicaid patients, over 25% had wait times of one month or more and another 10% had wait times of over 2 months. In discussing the wait times, the newly released report stated:

“For example, a number of obstetricians had wait times of more than one month, and one had wait times of more than two months for an enrollee who was eight weeks pregnant. Such lengthy wait times could result in a pregnant enrollee receiving no prenatal care in the first trimester of pregnancy.”

The report did say that primary providers such as gynecologists, internists and family physicians offered fewer appointments for Medicaid patients than specialists. However, even though more specialists did accept more new appointments, they had much longer wait times.

Marilyn Tavenner, Administrator for the Centers for Medicare and Medicaid Services said that the report reveals a number of areas that need to be addressed and that provider lists must be updated.

An additional problem facing Medicaid patients is how few doctors are willing to treat ones with certain illnesses. Dr. Rachel Chatters, a pediatrician in Lake Charles Louisiana commented:

“It’s nearly impossible to find specialty care for Medicaid patients of any age with diabetes, asthma, sickle cell anemia and certain other chronic illnesses.”

The bottom line revealed by the report is that more people may be signing up for Medicaid but fewer of them are able to find doctors who are willing to see them. That’s not what I call a successful program, but then very little about Obamacare is successful from the standpoint of the average American.

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