Poor Access to Care Under Medicaid 

Nationally, about one-third of physicians do not accept new Medicaid patients.[26] This is nearly double the proportion of doctors who have closed their practices to new Medicare patients (17 percent) and to new privately insured patients (18 percent).[27] Physicians are four times as likely to turn away new Medicaid patients as they are to refuse the uninsured who pay out-of-pocket (31 percent versus 8 percent).[28] Studies show it is harder for Medicaid enrollees to make doctors’ appointments than it is for uninsured patients who say they’ll pay out of pocket.[29]

In a 2011 survey of Michigan physicians, nearly one in six said they refused to treat any Medicaid patients.[30] This figure may not fully reflect the access problems for Michigan’s Medicaid enrollees. Some physicians will accept some — but not all — new Medicaid-enrolled patients who enquire about an office visit. In addition, some physicians will treat their current Medicaid patients, but will not accept new Medicaid patients. For instance, in the same survey of Michigan physicians, more than one-quarter (28 percent) said they were not accepting new Medicaid patients into their practice.[31] Indeed, a 2008-2009 survey found that many specialists in metropolitan Detroit did not accept Medicaid patients (see Graphic 2).[32] These specialists included:

  • 33 percent of dermatologists;[33]
  • 41 percent of family practitioners;[34]
  • 50 percent of obstetrics-gynecology specialists;[35] and
  • 67 percent of orthopedic surgeons.[36]

The exception to this pattern was cardiology; all cardiologists surveyed in 2009 said they accepted Medicaid.[37]

Graphic 2: Percentage of Physicians Not Accepting Medicaid in Metro Detroit, 2009

Graphic 2: Percentage of Physicians Not Accepting Medicaid in Metro Detroit, 2009 - click to enlarge

Source: “2009 Survey of Physician Appointment Wait Times,” (Merritt Hawkins & Associates, 2009), 4-8, http://goo.gl/Zytko (accessed May 16, 2013).