Just as states get ready to expand their Medicaid programs under Obamacare, low-income patients may find themselves with a fewer doctors to choose from because it simply doesn't pay enough for a physician to take government-subsidized patients.
In California, Dr. Ted Mazer, one of the few ear, nose and throat specialists in the San Diego area who still treats Medicaid patients, says that he won't be able to do so any longer because of the low reimbursement funds from the government, The New York Times reported.
"It's a bad situation that is likely to be made worse," Mazer said.
Medicaid already suffers from a shortage of doctors, especially when it comes to specialists. Only 57 percent of California doctors are willing to accept new Medicaid patients and another 10 percent are expected to drop Medicaid patients in the coming months.
The Congressional Budget Office has projected that $9 million Americans are expected to be added to Medicaid rolls in 2014. California is expected to add about two million people to its Medicaid program, more than any other state.
Community clinics that service Medicaid patients have begun hiring more doctors, nurses and other staff in preparation for the increase, but they usually don't staff specialists.
According to The Times, Obamacare tries to offset the payment rate problem by granting a two year increase for primary care givers averaging 73 percent, which will expire at the end of 2014. However, states have not been quick to increase the rate partly due to the temporary nature of the increase.
However, Dr. J. Mario Molina of California said that the temporary increase has made it easier to recruit more doctors to his network, Molina Healthcare, but he's still struggling to find specialists.
Mazer is head of a California Medical Association committee that deals with Medicaid problems and said that the managed-care plans he is contracted with "keep on sending us patients, and right now I'm scheduled four weeks out."
This is also creating a frustrating situation for patients who now have to wait a lot longer to see specialists like Mazer.
The news comes as Obama administration officials are bracing for another potential disaster on Saturday as the upgrades for the troubled Obamacare website's latest rollout are finalized.
An Obamacare marketing campaign is being put on hold because the White House fears that a rush of customers to the hobbled HealthCare.gov website could crash the system.
"Our concern is that we want to make sure that people have the right expectation going into this," Jennifer Palmieri, White House communications director, told The New York Times
"Early October was a frustrating experience for users," Palmieri said. "We are preparing for the outcome that we have as many or more visitors as we had on Oct. 1."
About 4.7 million people visited HealthCare.gov that first day, Obama administration officials told The Times.
Luke Chung, president of Virginia-based software developer FMS Inc., told CNN
that the administration's prediction that HealthCare.gov would work at 80 percent capacity was an impractical threshold in the software world.
"I don't know how to build something that's only 80 percent complete," Chung told CNN. "I don't even understand how that works."
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