Congress and States Work to Extend ACA’s Medicaid Primary Care Bump

By Sophia Duong

A hot topic recently has been the extension of the Medicaid payment rate increases for primary care services. The ACA required states to reimburse primary care physicians who treat Medicaid beneficiaries at the higher Medicare rate for 2013 and 2014. The rate bump has garnered large support from physicians and hospitals, and serves as an important vehicle to expand primary care access for Medicaid beneficiaries. Despite its popularity, the rate bump is set to expire at the end of this year without Congressional action.

But expiration will not happen quietly – three major signs of support to extend the bump have surfaced in recent weeks:

  • The Murray-Brown Plan. Last Wednesday, Senators Patty Murray (Washington) and Sherrod Brown (Ohio) proposed Senate bill 2694, which would extend the primary care rate increase for another two years. This bill also includes Medicaid payment rate increases for obstetricians/gynecologists, nurse-midwives, nurse practitioners, and physician assistants.
  • CHIP House Bill. Earlier this week, Representatives Pallone (New Jersey) and Waxman (California) introduced the House bill to extend funding for CHIP. The bill includes an extension of the primary care bump through 2019, and proposes to increase Medicaid rates for additional providers, such as physician assistants, nurse practitioners, obstetricians/gynecologists, neurologists, and psychiatrists.
  • States are taking matters into their own hands. Alabama, Mississippi, Colorado, New Mexico, Iowa, and Maryland are using their own funds to continue the Medicaid primary care bump through 2015. What’s interesting here is that Alabama and Mississippi did not accept federal funds to expand Medicaid, yet are willing to fund the rate bump out of their own pockets. Additionally, Alaska and North Dakota began paying primary care doctors in Medicaid at a higher rate before 2013.