National union for resident physicians signs onto a letter endorsing the House bill provisions on Medicaid payment rates to guarantee that the poorest and most medically-vulnerable Americans are not left behind by reform.

Washington, DC - Yesterday, the Committee of Interns and Residents/SEIU Healthcare joined a broad coalition of health care and HIV/AIDS advocates, physicians, nurses, health care providers, hospitals, labor unions, and community activists to sign a letter urging Congressional leaders now negotiating the final health care reform legislation to include provisions from the House bill that would bring primary care reimbursement rates under Medicaid into partity with Medicare rates for the same services within four years.  118 organizations in total signed the letter, which was delivered on Tuesday, January 12, 2010.

"This isn't just a question of economics - it's a question of access," said Dr. L. Toni Lewis, president of CIR.  "Increasing Medicaid eligibility to 15 million people is an unprecedented expansion of coverage to the poorest and most medically-vulnerable patients.  But those gains will be undermined if there aren't enough primary care physicians willing or able to take on this wave of new Medicaid patients."

While both bills would increase enrollement to Medicaid by an estimated 15 million people, the Senate bill does not address the low rates of reimbursement for for primary care providers.  The millions of low-income women, children, minorities and individuals with disabilities who rely upon Medicaid today already have difficulty finding their own primary care physician. While there's a general consensus that Medicare rates for primary care are too low, little attention has been paid to Medicaid, which average 66% of Medicare rates. This disincentive for providers to accept new Medicaid patients will be compounded with the new enrollees granted coverage through comprehensive health care reform.

"This problem is easy to fix, and the House bill would fix it," Dr. Lewis said.  "We need our legislators to stand with physicians and the patients we care for by preserving the House's fix to Medicaid reimbursement rates."

The full text of the letter follows:

Dear Majority Leader Reid, Speaker Pelosi and Chairmen Rangel, Waxman, Miller, Baucus, Dodd and Harkin:

As you craft the final health care reform bill, the undersigned organizations urge you to ensure meaningful access to care under the proposed Medicaid expansion by adopting the House provision to bring Medicaid reimbursement rates for primary care in line with comparable Medicare rates within four years.

While we strongly support expanding Medicaid to extend health coverage to low income individuals, we are very concerned that failure to address reimbursement disparities will weaken an already fragile network of Medicaid providers at a time when the demand for their services will be growing.

Medicaid rates average just 66% of Medicare rates for primary care services and are woefully inadequate to cover the cost of providing care. According to the Congressional Budget Office, the planned expansion will increase enrollment in Medicaid and the Children's Health Insurance Program by as many as 15 million beneficiaries. Those who rely on Medicaid to meet their health care needs include millions of low-income women, children, minorities and individuals with disabilities. The inadequacy of Medicaid reimbursement levels must be addressed in conjunction with the Medicaid expansion or we risk leaving our poorest and most medically-vulnerable residents behind despite the remarkable promise offered by health reform.

Please give high priority to ensuring access to care for Medicaid beneficiaries by adopting the House provision to adjust Medicaid payments for primary care to at least 100 percent of Medicare rates.

Thank you for your consideration.