Dec. 18—Nonelderly patients with Medicaid or other public insurance coverage were three times as likely to have physicians reject them due to their insurance, according to the Centers for Disease Control and Prevention (CDC).

In 2012 surveys examined by the agency, 8.3 percent of adults aged 18 to 64 years old with public coverage only were told within the previous 12 months that a physician's office or clinic did not accept their healthcare coverage. Physicians and clinics similarly rejected the insurance plans of 2.6 percent of private insured patients.

Publicly insured children faced similar ratios of rejection. The survey found 3.8 percent of publicly insured minors were rejected, compared with 1.3 percent of privately insured children.

The division among seniors was negligible, with similar percentages of Medicare-only and Medicare—plus private coverage patients rejected from care.

The rejection rates for nonelderly patients with public insurance were all higher than the 2.4 percent incidence of problems finding care reported by the general public.

Additionally, publicly insured patients were more likely than the uninsured to have been told that a physician or clinic would not accept them as new patients. The rates of rejection were 5.9 percent among nonelderly adults with public coverage, 3.1 percent uninsured, and 1.6 percent privately insured.

The greater access problems reported by Medicaid beneficiaries could have national consequences as the Affordable Care Act (ACA) allowed about half of the states to expand Medicaid coverage to millions more beneficiaries, beginning in 2014. Physician groups blame the low acceptance of Medicaid to its low payment rates, which the ACA raised to Medicare levels until the end of 2014. 

Echoing Earlier Findings

The survey data followed a September 2012 CDC report that concluded almost 90 percent of general physicians accept new patients with private insurance, but fewer than 75 percent accept new patients with public coverage, such as Medicare or Medicaid.

Medicaid had an even larger impact on physician access in a September 2012 study in the journal Health Affairs. That research 2011 federal physician survey data and found 31 percent of physicians would not accept new Medicaid patients, compared with 17 percent rejecting any new Medicare patients and 18 percent who would not accept any new patients with private insurance.

The latest CDC findings are based on census responses and interviews with 34,525 adults and 13,275 children. However, the CDC authors cautioned that the actual rates may differ because the surveys did not narrow respondents only to include those who had sought care in previous 12 months.

Publication Date: Wednesday, December 18, 2013