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, covering 72 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, with fewer enrollees losing coverage over time compared to those with private insurance. Other studies have similarly shown the crucial role of Medicaid programs in promoting health equity and improving health outcomes, particularly for low-income individuals. Medicaid expansion under the Affordable Care Act has been associated with increased insurance coverage, improved care access, and increased preventive service utilization.
However, despite the vast number of people covered by Medicaid, access to care is often limited. One of the biggest challenges facing Medicaid patients is finding doctors who accept Medicaid insurance. The availability of Medicaid providers varies significantly across states and even within states, leading to disparities 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 in providers not accepting Medicaid insurance, 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 could increase 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 is not creating new demand for health care services but simply ensuring that a sufficient supply of health care providers meets existing demand. Moreover, the program already partially covers the cost of 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 can access care without traveling long distances or struggling to find clinics that accept their insurance, the government must increase their reimbursements to health care clinics. This would incentivize more clinics to accept Medicaid insurance and provide more options for low-income 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-Shimari is an epidemiologist. Miriam Al-Saedy and Salsabeal Al-Saedy are medical students.
