Medicaid's Miserable Health Access

Roughly half of ObamaCare's coverage expansion comes via an expansion of Medicaid, the joint federal-state health program for the poor and disabled. Thanks to ObamaCare's giant-sized expansion of the program, it's set to become the single largest insurer in the nation, with about 76 million enrollees by 2021.

But Medicaid's patient access is remarkably poor. Children, in particular, have trouble finding doctors who will see them. According to a new report by the Government Accountability Office, at least 75 percent of physicians are enrolled in Medicaid and its sister program, the Children's Health Insurance Program (CHIP). Yet that doesn't guarantee access to care, especially in comparison to private insurance: While 79 percent of providers are currently taking privately insured kids as new patients, only 47 percent are taking new patients from children enrolled in Medicaid. 

Specialty care is even harder to come by, according to the GAO:

More than three times as many participating physicians—84 percent—experience difficulty referring Medicaid and CHIP children to specialty care as experience difficulty referring privately insured children—26 percent. For all children, physicians most frequently cited difficulty with specialty referrals for mental health, dermatology, and neurology.

Surely newly enrolled kids are still better off in Medicaid versus the alternative? Not necessarily. That's because millions of kids who end up on Medicaid or CHIP would have otherwise been insured privately. In 2008, the Congressional Budget Office estimated that about a third of the 5.8 million kids covered under a CHIP reauthorization would have been covered privately. In general, CBO estimates that "for every 100 children who gain public coverage as a result of SCHIP, there is a corresponding reduction in private coverage of between 25 and 50 children."