Study: Expanding public insurance doesn’t increase access to care. Paying doctors more does increase access.
Principal Findings: Children’s Health Insurance Program [CHIP] had a major impact on the extent and nature of children’s insurance coverage. However, it is not associated with any change in the aggregate quantity of physician services, and its associations with indicators of access are mixed. Increases in physician fees are associated with broad-based improvements in indicators of access.
Conclusions: The findings suggest that (1) coverage expansions, even if they substantially reduce patient cost sharing, do not necessarily increase physician utilization, and (2) increasing the generosity of provider payments in public programs can improve access among low-SES children, and, through spillover effects, increase higher-SES children as well.
Think about the devastating implications of this for ObamaCare! More below the fold. HT: Jason Shafrin.
When Congress expanded the CHIP program about three years ago, the Congressional Budget Office predicted that about one-quarter to one-half the 4 million newly enrolled children would lose private coverage (that presumably paid higher physician fees than CHIP). This study implies that the net result of the expansion is that up to 2 million children now have less access to care than they previously had.
ObamaCare will repeat the mistake when it enrolls about 16 million new people in Medicaid. Many will be converting from private coverage that pays physicians more than Medicaid pays (even with the somewhat higher rates for two years). The net result: millions of patients will have less access to care than they had before the reform.