Rhode Island spends more than any other state on its Medicaid program per enrollee, but apparently that’s not because local primary-care doctors are getting a windfall.
Doctors in Rhode Island get paid the nation’s lowest reimbursement rates by Medicaid, the state-federal health insurance program for the poor, relative to what private insurers offer, according to a 2009 Urban Institute study flagged by Forbes.com’s Avik Roy.
Rhode Island and New York both pay primary-care doctors rates that are only 29% of what they’d get from private insurers, the least in the nation, the study found. Rhode Island’s payment rate is far below those of the other New England states: Maine (42%), Vermont (54%), Massachusetts (62%), Connecticut (63%) and New Hampshire (73%).
The federal government limits the ability of states to scale back Medicaid coverage. “So, if states need to reduce Medicaid spending, but can’t make less people eligible for Medicaid, what do they do?” Roy writes. “Pay doctors less.” He suggests the Affordable Care Act will force more states to cut doctors’ rates.
Bloomberg’s Josh Barro counters that “expanded [Medicaid] participation is a good thing. The objective of the Medicaid program – which all 50 states have voluntarily agreed to participate in – is to provide health coverage to poor people. When eligible people do not participate, it is a policy failure.”
• Related: Chart: RI elders cost Medicaid 7 times more than kids, families (March 1)
(chart: Avik Roy/Forbes)