Practices seeing fewer uninsured due to Medicaid expansion

The ranks of the uninsured are shrinking, according to new research from the American Medical Association that showed they occupied a smaller share of physician patient mixes in 2016 compared to 2012.

The research indicates their shrinking percentile was driven largely by states that expanded Medicaid under the Affordable Care Act. Specifically, 75.6 percent of physicians had practices that treated uninsured patients in 2016, compared to the 2012 figure of 81.3 percent. The average share of uninsured patients in a physician practice patient mix was 6.1 percent in 2016, compared to 6.9 percent in 2012, the AMA said.

While uninsured patients constituted a smaller share of the practice patient mixes, Medicaid patients' share increased, driven mainly by physicians in the 31 states and the District of Columbia that expanded Medicaid programs.

[Also: Uninsured rate rises to 12.3% in third quarter, up from 11.7%]

For Medicaid expansion state physicians, the average Medicaid patient share rose to 17.6 percent in 2016 from 16.2 percent in 2012, and the average uninsured patient share dropped to 5.4 percent from 6.4. In contrast, among physicians in non-expansion states, there was essentially no change in Medicaid patient load from 2012 to 2016, and only a modest decline in uninsured involvement that was not statistically significant.

For physicians in non-expansion states, there was no change in Medicaid patient load and only a slight decrease in the uninsured, the AMA data showed.

"Expanding Medicaid has provided much-needed coverage to our low-income patients, improved access to care, and enhanced the health and well-being of the newly insured," said physician and AMA President David O. Barbe. "Medicaid expansion is not simply a budget issue. Lawmakers must also consider the real human effects of this decision, including the health and well-being of those who have gained coverage under expansion."

[Also: Suburban poor, uninsured turn to emergency rooms for care]

The AMA research also broke down the coverage mix. In 2016, private insurance covered 43.4 percent of physicians' patients, while Medicare covered 29.3 percent. Medicaid covered 16.9 percent, and workers compensation or other payer covered 4.3 percent. In 2012, private insurance covered 42 percent of physicians' patients, while Medicare covered 30.1 percent, Medicaid covered 15.9 percent, and workers compensation or other payer covered 5.1 percent.

As political uncertainty around healthcare swirls, one theme that has strongly emerged is that Medicaid expansion meant coverage for millions of people who used it as a means to seek care. From primary care to chronic disease management, the expansion of Medicaid had the potential to set off a positive, if somewhat slow-moving, ripple effect for public health. Now with political uncertainty swirling around healthcare legislation, and many Republican lawmakers looking to reduce Medicaid funding, these figures could shift back to high numbers of uninsured and uncompensated care for providers if new proposals do not account for that affected population.

Twitter: @BethJSanborn
Email the writer: beth.sanborn@himssmedia.com