Monica’s discussion of the article on health reform and children is one example of the negative effects that these changes can have. Similarly, this article from the NY Times addresses yet another potential consequence of change. In recent years, many states have been cutting funds for Medicaid, leaving those who qualify with limited resources and options. Many doctors and other health care providers are reluctant (or refusing) to take patients on Medicaid, especially practitioners who specialize. They lose money on these patients compared with those who have private insurance, so the financial payoff is not there.
With the Affordable Care Act, there is a great influx of people applying for Medicaid that is expected to occur over the next few years (approximately 15-20 million more people enrolling monthly). More people using government-paid insurance means less private insurance patients for health professionals. Will this change their practices? If they continue to refuse to help people on Medicaid, then the increase in the program really does not mean a whole lot for the newly covered, especially if they are in need of specialized care.
While the practitioners’ refusals themselves are threatening to the well-being of Medicaid recipients, the budget cuts that have been occurring nationwide are also problematic. Louisiana’s current situation is depicted in the article, and according to reports, Medicaid payments in the state have been reduced 15-20% over the past two years. Even with a Medicaid card in wallet, people are not getting the services that they need. Medicaid is soon to be the nation’s largest insurer, and without addressing issues of budgets and acceptance of patients, people will not be taken care of in an effective manner.
People on Medicaid have difficulty finding doctors who will treat them, but when it comes to finding specialists like neurologists, psychologists or pulmonologists, it is nearly impossible. Draven Smith is an 8-year-old who has been expelled twice due to disruptive behavior. He has been diagnosed with ADHD, but his mother cannot find a mental health specialist who will treat him. Not only does this child not have access to the help he needs, but he also cannot receive a proper education due to his condition. Can this system be changed in a way that maximizes benefits for all who are covered?