House Democrats' national budget proposal brings forward a $39 billion operating budget proposal for the two-year cycle beginning July 1. Spending increases are largely focused on education and funding raises for state employees, but Washington residents currently on the state's Medicaid program will continue to face issues regarding access, according to the Washington State Medical Association.
Approximately 1.7 million patients are currently enrolled in state-run Medicaid, including more than 750,000 children. State financing is critical in the functioning of Washington's healthcare system, yet funds needed to improve access to healthcare for the Medicaid population were absent from the budget plan, according to the WSMA's response to the proposed budget.
"Having access to insurance does not ensure access to care. Without a commitment by the state to support physicians who care for Medicaid patients, the burden is shifted to physician practices, which must decide whether to subsidize patient care at an economic loss — putting their entire practice at financial risk — or limiting the number of Medicaid patients they treat," said Brian Seppi, MD, president of the WSMA, which represents nearly 10,000 physicians and physician assistants in the state.
Almost three-quarters — 74 percent — of primary care physicians indicated they would reduce or stop seeing current Medicaid patients if reimbursement rates revert to pre-2013 levels, according to a recent study conducted by the Washington, Wyoming, Alaska, Montana and Idaho Center for Health Workforce Studies.
House Democrats also included a 20 percent increase in the business and occupation tax rate for service businesses — including independent physician practices — in their proposal. According to Jennifer Hanscom, CEO of the WSMA, this tax increase will negatively impact those who practice in private practices or independent medical clinics, which makes up about half of Washington's physicians.
"Our state made a commitment to reduce the number of its uninsured residents by offering them Medicaid coverage. Now they must follow through on their commitment by ensuring that these patients have access to care in their communities. Reducing physician payments for treating these patients and piling on additional taxes will not only jeopardize access to needed care for our state's most vulnerable patients, but put at risk the economic viability of independent, physician-run practices," said Dr. Seppi.