Former CBO Director Douglas Holtz-Eakin testified this week to the House Budget Committee that “Today, Medicare coverage no longer guarantees access to care.”[1]  A very definitive statement from someone who knows Medicare financing inside and out.  Moreover, Medicare access is virtually certain to worsen because of significant physician payment cuts relied upon in the Democrats’ takeover of healthcare law.

Holtz-Eakin continued “increasingly seniors enrolled in the Medicare program face barriers to accessing primary care physicians as well as medical and surgical specialists.  The New York Times, Bloomberg News, and Houston Chronicle are among many newspapers reporting that doctors are opting out of Medicare at an alarming rate.  For example, the Mayo Clinic, praised by President Obama and the [Independent Payment Advisory Board] IPAB’s architects will stop accepting Medicare patients at its primary-care clinics in Arizona.”[2]

A few key excerpts from these news stories:

“Many people, just as they become eligible for Medicare, discover that the insurance rug has been pulled out from under them.  Some doctors — often internists but also gastroenterologists, gynecologists, psychiatrists and other specialists — are no longer accepting Medicare, either because they have opted out of the insurance system or they are not accepting new patients with Medicare coverage…Doctors who have opted out of Medicare can charge whatever they want, but they cannot bill Medicare for reimbursement, nor may their patients.  Medigap, or supplemental insurance, policies usually do not provide coverage when Medicare doesn’t, so the entire bill is the patient’s responsibility.”[3]

“Texas doctors are opting out of Medicare at alarming rates…Two years after a survey found nearly half of Texas doctors weren't taking some new Medicare patients, new data shows 100 to 200 a year are now ending all involvement with the program...More than 300 doctors have dropped the program in the last two years, including 50 in the first three months of 2010…The largest number of doctors opting out comes from primary care, a field already short of practitioners nationally and especially in Texas.  Psychiatrists also make up a large share of the pie, causing one Texas leader to say, ‘God forbid that a senior has dementia.’”[4]

“The Mayo Clinic, praised by President Barack Obama as a national model for efficient health care, will stop accepting Medicare patients…at one of its primary-care clinics in Arizona…More than 3,000 patients eligible for Medicare…will be forced to pay cash if they want to continue seeing their doctors…A Medicare patient who chooses to stay at Mayo’s Glendale clinic will pay about $1,500 a year for an annual physical and three other doctor visits…[and] also will be assessed a $250 annual administrative fee.  ‘We’ve had many patients call us and express their unhappiness,’ [Mayo spokesman Michael Yardley] said, ‘It’s not been a pleasant experience.’”[5]

 All of this on top of worrisome recent survey results:

• The American Medical Association says nearly a third of primary care physicians restrict the number of Medicare patients in their practice; one in five physicians overall.[6]  Of note, the AMA survey also indicates 14 percent of physicians cancelled or postponed scheduled services to Medicare patients and 13 percent temporarily closed practice to new appointments in response to 2010 Medicare payment update delays.[7]  
• The American Academy of Family Physicians reports the number of its doctors simply not accepting Medicare patients has doubled in the past seven years.[8]
• The Physicians Foundation reveals 52 percent of doctors say health reform will compel them to close or significantly restrict their practices to Medicare patients.[9]

Leslie Norwalk—Former CMS Acting Administrator, Deputy Administrator, Chief Operating Officer, and Acting Director of the CMS Center for Beneficiary Choices—confirms Medicare access is a real and growing concern largely on account of aging population demographics and significant physician reimbursement cuts called for in current law.