Many doctors listed as Medicaid providers may not actually be accessible to patients. The NYT reports on a new survey released by the inspector general of the Department of Health and Human Services. Investigators called “1,800 providers listed by more than 200 health plans under contract with Medicaid in 32 states” to find out how many of these providers would see Medicaid patients. One-third no longer practiced at the address provided—they had moved or retired or were otherwise not there—with another 16 percent either not part of the Medicaid plan in question or not accepting new patients. And even when the providers were taking patients, the wait times to receive care cause their own problems:
“When providers listed as participating in a plan cannot offer appointments, it may create a significant obstacle for an enrollee seeking care,” [inspector general] Mr. Levinson said. “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.” […]
The delays can have significant implications for patients.
“For example,” the report said, “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.”Primary care providers, such as family doctors, internists and gynecologists, were less likely to offer appointments than specialists, the report said. But specialists tended to have longer wait times, with a median wait of 20 days, compared with 10 days for a primary care provider.
Supporters of the ACA have been quick to claim the law is working because it has lowered the uninsured rate, in part through the Medicaid expansion. But that expansion may create an increasingly large class of people who are “insured” but cannot get access in a timely fashion—or at all—to a doctor. In light of that, simply citing top-line statistics about the uninsured rate is not a very convincing way to prove a program is working.