The bottom line: Medicaid isn’t broken — at least, not any more than private insurance is.
Finding doctors: The biggest problem that’s usually cited with Medicaid is that people have trouble finding doctors who will take them. And there are troubles with low Medicaid provider reimbursement rates and physician access, but they vary around the country. It’s not hard to find a state, or more typically a region within a state, where physician access is a real problem.
- 74% of Medicaid beneficiaries see a doctor each year
- 69% for people with employer based private coverage see a doctor each year.
- People on Medicaid are also nearly just as satisfied with their health care as people with employer coverage.
Costs aren’t out of control: Medicaid spending did jump to 10.5% in 2015 with the Affordable Care Act coverage expansion, but it dropped to 5.9% in 2016 and is projected to grow by 4.5% this year.
And per capita Medicaid costs are not rising faster than costs for private insurance. In fact, they’re projected to grow more slowly.
Some would say that’s because Medicaid underpays providers, and it does pay substantially less than Medicare in many states. Others would say, good for Medicaid; it drives a tougher bargain with providers while getting results comparable to other payers.
The AHCA would take more than 800 billion dollars out of Medicaid over the next decade by reducing funding for the Medicaid expansion and capping federal Medicaid spending. The architects of the AHCA may believe Medicaid dollars are better spent elsewhere or not spent at all, or that somehow states can make Medicaid work better with far less money.
There are many principled conservative arguments for smaller government. But the argument that Medicaid is “broken” is not one of them; it is more urban legend than fact.