Kaiser Family Foundation Reports
April 27, 2011
Anna Sommers, Julia Paradise, Carolyn Miller
The Patient Protection and Affordable Care Act (ACA) includes two provisions with significant implications for the adequacy of the supply of primary care physicians (PCP) serving Medicaid enrollees. First, the ACA extends Medicaid eligibility to nearly everyone under age 65 up to 133% of the federal poverty level ($14,484 for an individual or $29,726 for a family of four in 2011). The Congressional Budget Office has estimated that 16 million people, mostly adults, will gain Medicaid coverage as a result of this expansion; another 16 million people are projected to gain private coverage through insurance exchanges established by the new law. Second, for 2013 and 2014, the ACA raises Medicaid payment rates for primary care services delivered by PCPs, to Medicare’s payment levels for the same services.
While access to primary care among adult Medicaid beneficiaries is generally good, the entry of 32 million newly insured people into the health care system will intensify competition among patients and payers for scarce primary care resources. To help inform policy to ensure adequate access to primary care for Medicaid enrollees, this study provides an assessment of which PCPs are most likely to respond to the changes under health reform by serving additional Medicaid beneficiaries, and it profiles important aspects of their practices.This article, written by researchers at HSC and the Kaiser Family Foundation (KFF) is available at the KFF Web site by clicking here.
This article was peer reviewed and jointly released in Medicare & Medicaid Research Review, the online research journal of the Centers for Medicare & Medicaid Services, Center for Strategic Planning. The article can be accessed at http://www.cms.gov/MMRR/ .