Kentucky Needs More Doctors Ahead of Medicaid Expansion

May 23, 2013

The planned expansion of Kentucky's Medicaid program coupled with a push to help the uninsured obtain health coverage could exacerbate the state's shortage of physicians, according to a report released Wednesday.

Deloitte Consulting, a technology firm that's helping to set up the Kentucky Health Benefit Exchange, unveiled the report showing Kentucky's 10,475 primary care physicians and specialists are far short of the actual need.

However, the firm concluded that Kentucky would need to find ways to increase the number of doctors and other medical professionals even if it didn't expand medical coverage to more than 600,000 new patients.

The report said Kentucky needs some 3,790 additional physicians, including primary care doctors and specialists, plus 612 more dentists, 5,635 more registered nurses, 296 more physician assistants and 269 more optometrists to meet current demand.

"With this information, we can work with many stakeholders to help address these long-standing issues," said Gwenda Bond, a spokeswoman for the Kentucky Cabinet for Health and Family Services. "It is our hope that this will serve as a starting point for many important conversations. We will be continuing to discuss legislative and policy options with those stakeholders in the coming months."

Gov. Steve Beshear announced earlier this month that he will expand the state's Medicaid program to cover an additional 300,000 people, most of them the working poor who don't now have insurance coverage. In addition, Beshear has ordered the creation of the health benefit exchange to help more than 300,000 others get insurance coverage.

Kentucky's Medicaid program already provides medical coverage to some 800,000 residents. Under the Affordable Care Act, Kentucky had the option of expanding coverage to some 308,000 additional people with incomes up to 138 percent of the federal poverty level. That means individuals making up to $15,860 a year would be eligible as would families of four making up to $32,499.

Washington will pick up the entire cost of the expansion for the first three years, and 90 percent over the longer haul.

Expanded Medicaid will be available starting Jan. 1, and uninsured people can start signing up this fall. So far, 21 states plus Washington, D.C., have accepted the expansion, while 14 states have turned it down. Another 15 states are still weighing options.

Beshear said a review by the University of Louisville and the accounting firm Price Waterhouse Coopers found that expanding Medicaid will create nearly 17,000 jobs in Kentucky and have a $15.6 billion positive economic impact between 2014 and 2021. He said the review also found that expanding Medicaid would have an $800 million positive impact on the state budget over the same period.

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