A new study from the Government Accountability Office (GAO) finds that since 2008, state efforts to reform Medicaid and make the low-income safety net program more efficient — likely spurred by provisions in the Children’s Health Insurance Program Reauthorization Act (CHIPRA) and Obamacare — have resulted in lower application processing times and high beneficiary coverage satisfaction comparable to private health insurance.
The study also found that the main hurdle to ensuring beneficiary satisfaction was the shortage of caregivers who accept Medicaid patients, mainly due to low payment rates for the doctors who take on Medicaid patients. As the GAO summarizes:
States reported making numerous changes to provider payments, provider taxes, and beneficiary services since 2008. While more states reported provider-rate and supplemental payment increases each year from 2008 through 2011, the number reporting payment reductions and increased provider taxes also grew. More states reported increasing services than limiting them.
Over two-thirds of states reported challenges to ensuring enough Medicaid providers to serve beneficiaries — including dental and specialty care providers. States cited Medicaid payment rates and a general shortage of providers as adding to the challenge. To attract new providers, over half the states reported simplifying administrative requirements or increasing payment rates.
In calendar years 2008 and 2009, less than 4 percent of beneficiaries who had Medicaid coverage for a full year reported difficulty obtaining medical care, which was similar to individuals with full-year private insurance; however, more Medicaid beneficiaries reported difficulty obtaining dental care than those with private insurance.
CHIPRA and Obamacare both expand the Medicaid program by vastly increasing the program’s funding, encouraging more aggressive enrollment efforts in the states, and rewarding states that successfully expand their coverage pool by insuring the poorest Americans.
The fact that Medicaid beneficiaries are self-reporting satisfaction with their coverage at the same rates as private insurance subscribers suggests that the program is working well — at least in states where it is well-funded. Safety net programs tend to enjoy high levels of satisfaction in general, with Medicare beating out private insurance with a 92 percent approval rating. Medicaid could be on the road to that same level of success if it’s adequately funded. But that would likely happen only if Republican governors decide to accept the federal government’s extremely generous funding to implement Obamacare’s Medicaid expansion.