January 26, 2015

The politicians and media voices pushing ObamaCare’s Medicaid expansion love saying cost really isn’t an issue because Washington pays 100% of the tab right now and 90% thereafter. In Marlin Brando’s classic Godfather line, it’s an offer we can’t refuse, right?

But as we’ve explained, Washington is already backing away from temporary increases ObamaCare made in Medicaid physician reimbursements, either cutting doctor fees or shifting costs to the states.

So much for ObamaCare’s promises of free Medicaid money from Washington.

A recent article from Georgia showed the impact these cuts are having on Medicaid doctors and patients. “The end of the federally funded raise means that Medicaid fees in Georgia will now be reduced by 34.8 percent, according to a recent Urban Institute study.

Some pediatricians describe the pay bump {cut ) as a children’s health issue. They say children on Medicaid generally have greater health and social needs.

“It’s a matter of valuing children as the future of the state,’’ says Dr. Jaquelin Gotlieb, who practices along with her pediatrician husband, Edward Gotlieb.

“I believe primary care doctors feel a significant responsibility to their patients,” adds Jaquelin Gotlieb, who is 68 and has practiced in Stone Mountain for almost four decades. “That’s why we have hung in there.”

If the pay isn’t restored, she says, “This is going to take some of them and push them over the edge.’’

Roughly two-thirds of the Gotliebs’ patients are covered by Medicaid or PeachCare, she says.

Dr. Eugene Cindea, a pediatrician at the Longstreet Clinic in Gainesville, says the extra money “allowed us to expand offerings to patients.”

“It felt good for physicians who were seeing a considerable number of Medicaid patients,” he says.

The goal of the pay hike, Cindea notes, was to increase the number of physicians who accept Medicaid patients.

Without the money, he says, it’s more difficult to devote staff to manage the chronic diseases of children. “It decreases the likelihood that we’ll expand in an underserved area,” he adds”.

Medicaid expansion supporters say all the new money will trigger a medical hiring boom. But the fee cuts sound like they are sending doctors over edge in Georgia.

In the story, a spokesperson for Georgia Governor Nathan Deal addressed ObamaCare’s costs getting pushed down to states. “She called the pay hike expiration “one of the early, blatantly obvious examples of Obamacare unloading costs onto the states. This was a short-term Band-Aid to a long-term problem, and now the states are left holding the bag.”

North Carolina is holding the same bag. Medicaid doctor reimbursements are suddenly being chopped 20% as temporary ObamaCare money disappears.

And ObamaCare’s promise to pay for Medicaid expansion is different? Don’t bet on it.

There’s another point to remember, too. While the billions Medicaid expansion costs go for free health insurance for able bodied adults many of whom don’t work, the Medicaid physician reimbursement cuts ObamaCare imposes now hurt care for poor children, the elderly and the disabled. Talk about misplaced priorities.