Medicaid is the government insurance program for low-income citizens. Many on Medicaid are permanently disabled. Some are low-wage workers. Because the payment rates to doctors is so low, many, especially high-priced specialists, are not accepting any new Medicaid patients. In some cases, there are doctors who spend a day or two a week working in non-profit clinics, and they refer Medicaid patients away from their private practice to these clinics. General practioners sometimes are able to convince a specialist who they personally know to take a Medicaid patient who the specialist usually would not take. Sometimes, a doctor has to plead with a specialist to see a patient.
Many Medicaid plans are now run by HMOs who have lists of doctors who accept Medicaid. These lists are sometimes inaccurate and out-of-date. The patients are advised to call the HMO if they can't find a doctor. The insurance companies who run the plans say that having to wait to see a doctor for months on end is unacceptable. In Michigan, a non-profit community mental health center stopped seeing Medicaid HMO patients because it didn't pay them enough to be able to afford to continue seeing them, even though community mental health centers were orignally created largely to serve people who may not be able to afford mental health services from a private practitioner and who,in many cases, who have a chronic mental health condition. In MIchigan, something like 88% of all physicians once took Medicaid; now the number has dwindled to something like 61% or so, and may be continuing to drop. State and federal public officials had better find a way to raise the reimbursement rate for doctors and hospitals for Medicaid, which is part of the health care reform program that was enacted.