According to data compiled by the Kaiser Family Foundation, in fiscal year 2010 the average Medicaid payment per enrollee was $5,563. To be sure, there was a wide variance: For aged Medicaid enrollees the average payment was $12,958, and for disabled enrollees it was $16,240. The average for adults was $3,025, and for children it was $2,359.
Medicaid enrollees have terrible access to care, according to a number of studies discussed in John Goodman’s Priceless (chapter 15). New research published in JAMA Internal Medicine suggests that it would be better simply to give Medicaid patients this money and let them spend it directly on medical care.
Posing as patients, researchers made almost 13,000 calls to doctors’ offices in ten states, seeking appointments for a variety of ailments. Those posing as privately insured patients got appointments 85 percent of the time. Those posing as patients on Medicaid got appointments only 58 percent of the time. Researchers also posed as uninsured patients who were willing to pay in full at the time of the appointment.
The result? For appointments costing more than $75, 78 percent of the “uninsured” researchers got a medical appointment — a success rate 36 percent higher than for those posing as Medicaid patients and quite close to those posing as privately insured.
The policy implication? Taking Medicaid money away from Medicaid bureaucracies and giving it to low-income people to pay directly for health care would increase access significantly.
From Dr. Scott Goottlieb For the individual insurance market (plans sold directly to consumers); among the ten states seeing some of the sharpest average increases are: Delaware at 100%, New Hampshire 90%, Indiana 54%, California 53%, Connecticut 45%, Michigan 36%, Florida 37%, Georgia 29%, Kentucky 29%, and Pennsylvania 28%.