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Medicaid Expansion under the ACA

posted on Thu, Aug 1 2013 12:00 am by Southeastern Region

Recently the Network received a question from a local health official on Medicaid expansion under the Affordable Care Act (ACA). The official specifically asked whether the fact that many healthcare providers do not accept Medicaid will reduce the effectiveness of expanded coverage and whether any measures are being taken to incentivize providers to accept Medicaid.

The Network responded with an analysis of the issue as well as a referral to a resource from the National Health Law Program (NHeLP). The Network explained that the ACA addresses the potential problem raised by the official in several ways:

  • The ACA appropriates $11 billion to increase capacity at federally qualified health centers, rural health clinics, and community health centers. The ACA also appropriates $1.5 billion for scholarships and loan repayment for primary care providers who work in medically underserved communities.
  • The ACA temporarily increases Medicaid primary care payments, thereby incentivizing providers to accept Medicaid patients
  • As the program expands, the Medicaid population will also grow, potentially incentivizing providers to accept Medicaid payments because of the greater overall volume.
  • As Medicaid eligibility requirements are expanded and better-off individuals enter the program, the ability of Medicaid recipients to demand better access to services may also improve.
  • The ACA provides substantial investments in efficiency, which should boost provider productivity.

The Network also referred the official to an issue brief from the National Health Law Program, entitled “Primary Care Provider Capacity and the Medicaid Expansion.”

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