Many Docs Reject Medicaid -- A Cause For Concern As The Expansion Approaches

McClatchy reports that projections highlight how the shortage of physicians in general as well as those who choose not to accept Medicaid patients could undermine the health law's intent. Also in the news, fits and starts surround this health law provision in Pennsylvania, Arizona, Texas, Louisiana, Ohio and Colorado.

McClatchy: Most Doctors Still Reject Medicaid As Program Expansion Nears
Because of the program's history of low payments, fewer than half of U.S. doctors and other health care professionals accept Medicaid patients, according to a recent study. For those that do, getting an appointment sometimes can take months because of the high demand, particularly among specialists. The problem is worse in rural areas such as Bonifay, in the Florida Panhandle. While 20 percent of Americans live in less-populated parts of the country, only 10 percent of U.S. doctors practice there. That's why 77 percent of the nation’s 2,000-plus rural counties are designated as health professional shortage areas, according to the National Conference of State Legislatures. Nationwide, the lack of doctors is a growing problem that will only worsen as some 27 million people get health coverage by 2016 as part of the Patient Protection and Affordable Care Act (Pugh, 5/15).

The Associated Press: Corbett Aide Doesn't Expect To See Pa. Medicaid Expansion In 2014
A top aide to Gov. Tom Corbett said expanding Medicaid eligibility in Pennsylvania under a sweeping federal health care law probably would not take effect before January 2015, even if the governor embraces the idea that would provide taxpayer-paid health care insurance to hundreds of thousands of residents. Beverly Mackereth, Corbett's Department of Public Welfare chief, told the Pittsburgh Post-Gazette on Friday that the administration would need until 2015 to negotiate with the federal government and create the program (5/13).

The Associated Press: Speaker Tobin Key To Medicaid Expansion Deal
Gov. Jan Brewer's proposal to expand the state's Medicaid program to 300,000 more poor Arizonans may pass or fail based on just one person in the Legislature: Republican House Speaker Andy Tobin. The trick for Brewer is figuring out just what Tobin wants in exchange for his support. And he's not making it easy (Christie, 5/14).

The Texas Tribune: Budget Rider Could Lay Out Terms For Medicaid Reform
The fate of Medicaid reform in Texas could rest solely on an up-or-down vote on the 2014-15 budget. State Rep. John Zerwas, R-Simonton, a member of the conference committee that is hashing out the differences between the House and Senate budget plans, said Monday he's relatively confident that a rider stipulating the Legislature's preferred Medicaid reform terms — like cost containment measures and private market reforms — for any deal with the federal government is "sticking" to the 2014-15 budget (Ramshaw and Aaronson, 5/13).

New Orleans Times Picayune: Federal Proposal For Cutting Safety-Net Money Supports Louisiana Decision To Decline Medicaid Expansion, State Says
A top Louisiana health agency official on Monday said a proposed federal rule cutting the money that funds the state's safety-net hospitals supports Gov. Bobby Jindal's decision to decline to expand the Medicaid program for the poor. The U.S. Department of Health and Human Services released a proposal for how the agency would cut "disproportionate share hospital" payments that finance hospital care for the uninsured. In Louisiana, this money is largely funneled to the LSU public hospitals that provide the bulk of the care for uninsured people. The Jindal administration and LSU are currently working on proposals to privatize operations of the public hospitals (Maggi, 5/13).

Cleveland Plain Dealer: Ohio Senate President Keith Faber Signals Hope For Medicaid 'Reform' But Not Kasich-Style Expansion
Ohio Senate President Keith Faber told a City Club of Cleveland crowd Monday that he expects state legislators to tackle Medicaid "reform" by the end of the year. But the Republican from Celina is not optimistic that a deal will reached before the June 30 deadline to pass the state's two-year budget. He also doubts the final product will resemble the Medicaid "expansion" Gov. John Kasich favors (Gomez, 5/13).

The Associated Press: Colorado Medicaid Expansion Signed Into Law
An expansion of Medicaid eligibility that's expected to add 160,000 adults to public health care assistance in Colorado was signed into law Monday. The expansion is part of the federal health care overhaul that 22 states and Washington, D.C., have accepted as of last week (Moreno, 5/13).

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