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Invited Commentary
June 2014

Calling All DoctorsWhat Type of Insurance Do You Accept?

Author Affiliations
  • 1Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco
JAMA Intern Med. 2014;174(6):869-870. doi:10.1001/jamainternmed.2013.13421

Through coverage expansion, the Patient Protection and Affordable Care Act (ACA) is expected to reduce a major barrier to health care access, the cost of care. However, the law does not ensure that an adequate number of physicians are available and willing to accept a patient’s form of coverage.

One of the main ways that the ACA expands coverage is through the Medicaid program. One particular concern has been whether enough physicians are available to meet the demands for the care of these patients.1 Some of the greatest increases in Medicaid coverage are projected to occur in geographic areas that already have practitioner shortages regardless of payment type. Low Medicaid reimbursement rates further compound the problem. In general, Medicaid programs pay physicians less than Medicare and commercial insurers.2 Physicians are not required to accept Medicaid patients, and research indicates that physicians are less willing to accept these patients in states with lower payment rates.3

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