How Expanded Medicaid Affects Physicians and Patients

Under the Affordable Care Act, states were mandated to expand Medicaid. However, the Supreme Court ruled that states cannot be forced to adopt the expansion. As a result, only about half the states have expanded their Medicaid programs. Colorado is one of the states that did sign the expansion into law. How does this legislation affect physicians and patients? 


In a paper entitled Annals of Internal Medicine, The American College of Physicians details how the Medicaid expansion will impact physicians and their patients. Officials in Colorado estimate that the expansion will offer health care coverage to an additional 160,000 residents of our state that previously did not qualify. In addition to offering coverage to more people, the new Medicaid must include the 10 essential benefit categories outlined in the legislation, including expanded preventive services. 

For physicians, the expansion means fewer uninsured patients. That translates to reducing the volume of uncompensated care and uncollectible accounts. In states that refused to expand, many citizens will continue to be in the gap of the uninsured because they fall below the income level required to purchase coverage through Obamacare's marketplaces, but they do not qualify for Medicaid. As a result, physicians and hospitals will continue to absorb the uncompensated costs. That means physicians and hospitals in Colorado have fewer uninsured patients overall. Additionally, the preventive services expansion alone can potentially stave off serious complications that could increase the cost of uncompensated care even more if left untreated. It is the state's hope that physicians who previously did not accept Medicaid will now start doing so. 

What Patients Need to Know

One of Medicaid's biggest challenges is making the community aware of the expansion. Many residents of Colorado may not realize they now qualify. Physicians can refer patients to Connect for Health Colorado to find out if they qualify. Coverage under the expanded program started January 1, 2014. However, residents have been able to apply since October. Unlike the Obamacare marketplaces, there is no deadline to apply. 

Medicaid expansion is just one of the changes physicians need to consider under the Affordable Care Act. While many changes are good for the health care community at-large, adapting medical practice management is a challenge. 

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