6 States, D.C. Extending Medicaid Pay Raise Next Year To Primary Care Doctors

Just six states and the District of Columbia will use their own money in 2015 to sustain the federal Medicaid pay raise to primary care doctors, which was a key provision of the Affordable Care Act intended to make sure millions of low-income people enrolling in the expanding insurance program have access to a physician.

Interestingly, two of the states extending the pay raise are Alabama and Mississippi — neither of which expanded Medicaid under the health law. The other states extending the pay raise next year are Colorado, New Mexico, Iowa and Maryland, according to interviews with state officials and the American Medical Association. Those four states expanded their Medicaid eligibility to cover everyone with incomes less than 138 percent of the federal poverty level, or about $15,900 for an individual.

Alaska and North Dakota paid primary care doctors in Medicaid the higher rates even before the health law’s provision took effect in 2013. The other 42 states will let the Medicaid pay rates revert back to their 2012 levels. Under the law, Medicaid fees for primary care increased in 2013 and 2014 to the same amount paid under Medicare. While Medicaid fees vary by state, the change meant an average 73 percent pay increase nationally, according to a 2012 study by the Kaiser Family Foundation. (Kaiser Health News is an editorially independent program of the foundation.)

Nationally, it’s unclear whether the higher fees attracted more doctors into Medicaid or made doctors more willing to treat more Medicaid patients. The Obama administration is not collecting any data to show the impact of the higher fees, said a spokeswoman for the Centers for Medicare & Medicaid Services. State Medicaid officials also have not studied the impact.