According to a recent New York Times article, in a survey of 32 states, the inspector general of the Department of Health and Human Services (HHS) found that half of the providers surveyed (who were listed as participating with one of the state’s Medicaid managed care plans) could not offer appointments to enrollees. Of these providers, one-third were no longer at the listed location; another 8 percent did not participate with the listed health plan; and another 8 percent were not accepting new Medicaid patients.
Legal Aid has long advocated for access to health insurance and quality health care services in order to improve health care outcomes of our low-income client population. As we have repeatedly noted, the District of Columbia has made an admirable commitment to expanding access to health insurance through Medicaid, the DC Health Care Alliance Safety Net program and the creation of DC Health Link (a state exchange implementing the private insurance portion of the Affordable Care Act). However, due to the inadequacy of Medicaid provider networks, far too often, our clients experience what my former colleague Stephanie Akpa referred to as “the gap between having health insurance and having meaningful access to health care services.”
The recent study by the HHS inspector general confirms that this gap is being experienced on a national level. (See the October blog by Stephanie Akpa about the New York Times preview of this study.) As we noted in October, the District is studying the adequacy of its Medicaid managed care organization provider networks. The District’s latest managed care report notes that all three of the District’s Medicaid managed care organizations have impaneled more primary care providers, pediatricians and dentists than required under the organization’s contract with the District. However, what is not addressed is the availability of specialists and other vital services such as obstetrics for Medicaid beneficiaries. (The HHS inspector general report specifically noted the difficulty of finding care in these areas.)
Not surprisingly, there is still a great deal of work to do in translating the District’s impressive commitment to promoting access to health insurance to its residence into the promise of timely, quality health care services. Legal Aid will continue to work towards this goal with the hope of improving health care outcomes for our clients and all District residents.