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Strengthening Medicaid

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Everyone deserves access to quality health care. To ensure low-income patients enrolled in Medicaid receive needed care, the AMA works diligently at the state and federal levels to improve Medicaid programs, expand coverage options and make it easier for physicians to see Medicaid patients.

Access to Care

Obtaining health insurance does not necessarily ensure better access to health care. Too often Medicaid patients face barriers to care, resulting in more frequent emergency department visits, delayed treatment of chronic conditions and poorer health outcomes.

Research demonstrates that low Medicaid reimbursement rates significantly affect a physician’s ability to accept new Medicaid patients. Physicians have a strong sense of responsibility to provide care for Medicaid patients, but cannot remain economically viable if they lose money on the care they provide. Without enough participating physicians, patients may have coverage but not real access to care.

To expand access to care, the AMA works with state advocates to fully fund the Medicaid program and increase physician participation with policies to streamline enrollment, ensure fair audit procedures and improve managed care programs.

Expanding Coverage

To date, 31 states and the District of Columbia have expanded Medicaid coverage under the Affordable Care Act (ACA) to individuals with incomes up to 133% of the federal poverty level. Since this change, states have enrolled over 14.5 million new people into Medicaid, bringing total enrollment to nearly 72 million people nationwide.

The AMA works with advocates and policymakers at all levels of government to identify realistic coverage options for the uninsured and supports expansion plans that best meet the needs and priorities of states and low-income patients.

In many states, policymakers are testing new ways to serve the Medicaid population. Reform efforts must ensure that Medicaid is a viable and effective program to provide health insurance coverage to low-income individuals, seniors and the disabled. Changes in the financing of Medicaid should not undermine the overall coverage gains that have occurred under the ACA, particularly for individuals with the lowest income.

Issue Briefs

Model Legislation

Other Resources

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