The Times West Virginian

West Virginia

July 9, 2013

W.Va. may lack doctors for Medicaid expansion

Most physicians who accept Medicaid limit the number of patients

CHARLESTON — West Virginia might not have enough doctors to care for Medicaid patients when the government-sponsored insurance program is expanded next year, the executive director of the West Virginia State Medical Association said.

Evan Jenkins said that most doctors who accept Medicaid limit the number of patients they see, which likely will make it difficult for some low-income patients to find a primary care physician.

“A lot of folks will dedicate a certain number of patient slots for Medicaid. When those are filled, they don’t take any new patients,” Jenkins told the Charleston Daily Mail.

Medicaid is accepted by about 2,000 primary care doctors in the state, said Penney Hall, Medicaid spokeswoman for the state Department of Health and Human Resources.

Medicaid reimbursements paid to doctors are less than those paid by private health care insurance or Medicare,

“I’m not aware of any medical practice that could survive financially ... solely on a Medicaid patient population,” Jenkins said. “There’s only so many hours in the day and so many patients you can see.”

The Medicaid expansion, announced in May by Gov. Earl Ray Tomblin, will extend coverage to an estimated 91,500 uninsured low-income patients.

Currently, about 183,000 West Virginian residents are enrolled in Medicaid or the Children’s Health Insurance Program. This number is expected to grow to about 277,000 by 2016, according to an actuarial report commissioned by the state Insurance Commissioner’s office.

West Virginia faces an October deadline to have a Medicaid expansion plan in place under the federal Affordable Care Act. State officials have been awaiting final rules from the federal government, which were released Friday.

The more than 600-page document released by the federal Centers for Medicare and Medicaid Services outlines how states should proceed with expansion. It addresses eligibility requirements, adds “flexibility regarding benefits and cost sharing for state Medicaid programs,” and provides guidance for states in implementing health insurance exchanges, among other things.

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