Recently in The New York Times, Robert Pear highlighted the major problems with the Medicaid program. His findings reveal that having a Medicaid card in one’s wallet is of little use if it doesn’t give beneficiaries access to the care they need.

A woman with several herniated discs and pain in her neck and arms told Pear that her Medicaid card is “a useless piece of plastic. I can’t find an orthopedic surgeon or a pain management doctor who will accept Medicaid.”

Pear interviewed doctors and Medicaid enrollees in Louisiana and reported that access problems are systemic due to low provider payment rates. In fact, Obamacare makes this problem worse by preventing states from reducing program eligibility. This leaves states with the options of either cutting provider payments or slashing benefits. Oregon Governor John Kitzhaber is proposing a 19 percent across-the-board cut for Medicaid providers. These cuts represent a top-down attempt to control Medicaid costs that will only worsen the program and harm its enrollees.

Ignoring Medicaid’s problems, Obamacare expands the program to cover over 20 million additional individuals. Pear reports that Louisiana officials expect to enroll an additional 467,000 people in Medicaid, and the state estimates that 40 percent of individuals added to Medicaid’s rolls will use it as a replacement for private insurance. This “crowd out” effect on private insurance already exists: Dr. Kim Hardey, an obstetrician-gynecologist in Lafayette, said that many of his patients have jobs with private insurance but switch to Medicaid when they become pregnant to avoid premiums, deductibles, and co-payments.

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