Declining Medicaid Fees and Primary Care Appointment Availability for New Medicaid Patients.

Medicaid reimburses physicians at a lower rate and fewer physicians participate in Medicaid when compared to other insurance types. To encourage provider participation in Medicaid, the Affordable Care Act (ACA) increased Medicaid fees to Medicare levels for primary care providers in 2013 and 2014. As expected, the bump in fees resulted in an increase in primary care appointment availability for new Medicaid patients, with larger increases occurring in states with larger increases in fees. Despite the improvements in access, most states returned to lower reimbursement rates in 2015. The question is: did the gains in access in Medicaid erode once fees declined?