Need to see a dermatologist in Philadelphia? If you are on Medicaid you’ll have to wait a staggering 49 days, according to recent Merritt Hawkins survey. This is no anomaly: Medicaid has earned a terrible reputation when it comes to access to care. Patients find it diffcult to find doctors because Medicaid reimbursment rates are significantly lower than private insurance rates and sometimes lower than the cost of care itself.
Given these issues, it’s of little surprise that insurance companies are having a hard time signing up medical providers for the new Healthy PA insurance plans. Alex Nixon at the Tribune Review explains:
Highmark Inc., the state’s largest health insurer, said it won’t participate in Corbett’s Healthy PA program because it couldn’t sign enough doctors to its network.
UPMC Health Plan is reducing the number of regions where it is participating from five to four, said John Lovelace, president of the health giant’s Medicaid products unit.
The original Healthy PA waiver asked the federal government to place newly-eligible adults in private plans, with higher reimbursments, paid for by taxpayers. The federal government denied that request. In fact, they denied the vast majority of the administration’s 24 requests to improve Medicaid. Now the state is overseeing the creation of new Medicaid managed care plans, and once again, the federal government is standing in the way of quality care.
Instead of expanding a broken system, Pennsylvania should help expand the supply of providers by incentiving more charity care and loosening licensing laws to allow highly trained providers, like nurse practitioners, open their own offices. This is how we can truly improve access to care for needy Pennsylvanians.