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Sunday, May 27, 2018
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State medical lobby ties support for Medicaid expansion to increased doctor pay

In a significant sign of physician backing for expanding Medicaid under the Affordable Care Act, or Obamacare, the Florida Medical Association now says it favors the idea.

The FMA, the premier trade association for Florida doctors, is normally a politically conservative group, though non-partisan, making its stance a major breakthrough in the eyes of Obamacare and Medicaid expansion supporters.

But the FMA attached one significant condition: It said it backs Medicaid expansion only if doctors get paid more for treating Medicaid patients.

The resolution passed unanimously by the organization in Orlando this weekend conditions its support on increasing Medicaid payment rates for all physicians to the same levels they get for treating Medicare patients.

Getting those reimbursement rates raised could be a tall order, according to a key backer of the ACA.

Medicaid, the national health care plan for the poor, normally is paid for jointly by states and the federal government.

But the Affordable Care Act, in order to get health coverage to more Americans, offered states a deal: It would pay the full increase in cost if the states expanded Medicaid to cover more people.

In 2013, the Republican-controlled Florida House refused to accept the money, an estimated $51 billion over 10 years. Critics contend that cost the state thousands of jobs as well as preventing many Floridians from getting coverage; the Republicans said they don’t trust the federal government to pay the tab.

Gov. Rick Scott initially said he supported expansion, but made no effort to convince the Legislature to act on it.

Mona Mangat, a St. Petersburg physician who’s head of Doctors for America, the national physician group in favor of the ACA, said the law temporarily raised Medicaid reimbursement rates to Medicare levels, but only for primary care doctors.

The Legislature this year declined to fund the reimbursement increases when they expire at the end of this year, and didn’t seriously consider Medicaid expansion.

Instead, other changes that converted Medicaid to a managed care program appear to have lowered reimbursement rates, Mangat said.

Nonetheless, she said of the FMA action, “This is really big news. It adds the FMA’s voice to thousands of others across the state.”

Mangat said the national organizations of obstetrician-gynecologists, pediatricians, and family care specialists all have called for the expansion, and the state chapters of those groups backed the idea in comments at the FMA’s meeting.

FMA general counsel Jeff Scott said the group took its stance because, “increased access to care for an enlarged Medicaid population will only come about if there are adequate numbers of physicians to care for these patients. … Current payments levels (which in many instances do not cover the cost to provide care) are grossly inadequate and serve as a disincentive to physician participation in the Medicaid program.”