One early evening in June, we sat in the second row of a Health Sciences Building classroom with 79 other students enrolled in the Summer Medical and Dental Education Program (SMDEP). We were excited to hear a guest lecture from a program alumnus, a clinician who shared that he, too, had lived in an underserved community, had Medicaid insurance, and relied on community clinics growing up. He concluded his presentation by stating that he was now a successful doctor who enjoyed serving his community. Aside from his inspiring success story, a quick Google search revealed that this doctor worked at his own private practice, primarily serving Washington’s wealthiest patients. When we asked if he saw patients with Medicaid insurance, he confirmed that he did not. This sparked a low murmur in the room, as most of us felt disappointed to know that this doctor–who understood the struggles of accessing care through Medicaid–chose not to serve those in need.
Although some health care providers may not accept Medicaid, it remains the largest payer for health care in the United States, covering72 million people in 2020. The importance of Medicaid programs in improving access to health care and reducing the rate of uninsured individuals cannot be overstated. A recent Annals study by Ndumele et al. found that Medicaid enrollment provides significant stability in health insurance coverage, withfewer enrollees losing coverage over timecompared to those with private insurance. Other studies have similarly shown thecrucial role of Medicaid programsinpromoting health equityandimproving health outcomes, particularly forlow-income individuals. Medicaid expansion under the Affordable Care Act has been associated withincreased insurance coverage,improved care access, andincreased preventive service utilization.
However, despite the vast number of people covered by Medicaid, access to care is often limited. One of thebiggest challenges facing Medicaid patientsis finding doctors who accept Medicaid insurance. The availability of Medicaid providers varies significantly across states and even within states, leading todisparities in the number of providers accepting Medicaid. This limits access to care for low-income individuals and underscores the need to increase government reimbursements to health care clinics accepting Medicaid. A low reimbursement rate often results inproviders not accepting Medicaidinsurance, limiting the number of providers willing to see Medicaid patients. Policymakers must take a proactive approach to strengthen and expand Medicaid programs to ensure that all individuals, regardless of income, can access care and take advantage of preventive services.
Despite the clear benefits of increasing government reimbursements, some critics argue that doing so couldincrease taxpayers’ health care costs. However, this argument ignores the fact that Medicaid patients already receive care through the program. By incentivizing doctors to accept Medicaid patients, the government isnot creating new demand for health care servicesbut simplyensuring that a sufficient supply of health care providers meets existing demand. Moreover, the programalready partially covers the costof providing health care services to Medicaid patients. By increasing reimbursement rates, the government can ensure that this coverage is sufficient to attract a robust network of health care providers.
To ensure that low-income individuals canaccess care without traveling long distancesorstruggling to find clinicsthat accept their insurance, the government must increase their reimbursements to health care clinics. This wouldincentivize more clinics to accept Medicaid保险和为低收入家庭提供更多的选择individuals to receive care close to their homes or access specialized care. The stability in coverage and improved access to care provided by Medicaid programs are critical for reducing health disparities and improving health outcomes for low-income populations. As health care professionals, we are responsible for advocating for policies that promote equity and ensuring that all patients, regardless of their insurance status, have access to the care they need.
Fatima Al-Shimariis an epidemiologist.Miram Al-SaedyandSalsabeal Al-Saedyare medical students.