Medicaid Expansion: Poor Quality Health Care for All

Robert Moffit /

With 48.9 million Americans projected to be uninsured in 2010, both Senators McCain and Obama are right to address this problem. While McCain’s health plan focuses on reducing this number through increased private coverage and tax incentives, Obama’s health proposal utilizes a different mechanism, expansion of government coverage as well as Medicaid and SCHIP, among other things. It’s this expansion of low quality delivering public programs that should have eyebrows rising.

Doctors often have trouble being reimbursed fully through Medicaid (e.g. Medicaid childbirth pays half the private sector rate), so they limit the number of Medicaid patients they treat. According to one survey, one third of physicians do not treat Medicaid patients and another third admitted that they limit their Medicaid practice. In Texas for example, 60 percent of physicians will not accept new Medicaid patients. Subsequently, Medicaid patients end up emergency rooms twice as often as the uninsured and four times as often as people with private insurance. This is alarming because covering people with insurance is suppose to keep people OUT of expensive emergency rooms, not make visits more frequent.

Senator Obama’s plan would increase the number of uninsured covered under Medicaid and SCHIP while reforming neither program. So, in affect, he would be exacerbating existing access and quality problems. What good is insurance when you cannot access a doctor? Quality health care means having the right diagnosis and the right treatment at the right time. The Obama Medicaid expansion promises none of that, and for Medicaid patients just more of the same. Some “Change.”

Nathan Lamborn co-authored this post