The PPACA provision that bumped Medicaid primary care payments up to Medicare rates expires Thursday, leading to a 42.8 percent average drop in fees for Medicaid primary care services, according to a study from the Urban Institute.
Funded by the federal government, the two-year increase in Medicaid fees gave physicians a financial incentive to accept more Medicaid patients. Conversely, the cuts may lead many physicians to stop accepting new Medicaid patients.
Fifteen states announced plans in October to continue the increase or part of the increase next year using state funds. However, these states only cover 15.6 percent of the nation's Medicaid beneficiaries. The states that plan to continue the increase are Alabama, Alaska, Colorado, Connecticut, Delaware, Hawaii, Iowa, Maine, Maryland, Michigan, Mississippi, Nebraska, Nevada, New Mexico and South Carolina. A number of states are undecided.
In the 24 states planning to let the fee bump expire, Medicaid payments for primary care services will be cut almost in half, according to the report. These 24 states will experience a greater average drop in fees when federal funding expires, at 47.4 percent. These states account for 71.3 percent of Medicaid beneficiaries and include the most populated states in the nation.
Physicians in the seven largest states by population size will all face a decrease of 40 percent or more in Medicaid payments, according to the report. Among these seven states, California, Illinois, New York and Ohio will experience the most strain, as they notably expanded Medicaid enrollment since 2013.
The 24 states planning to let the fee increase expire are: California, Florida, Idaho, Illinois, Indiana, Kentucky, Louisiana, Massachusetts, Minnesota, Missouri, New Jersey, New York, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Texas, Utah, Vermont, Washington and the District of Columbia.
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