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In a March email blast, a Texas state senator who’s a physician said that in a meeting with President Donald Trump, she’d promoted federal block grants to give states more sway over the costs of Medicaid, the decades-old federal-state insurance program for poor people and those with disabilities.

Donna Campbell, R-New Braunfels, further said, “Seven out of ten doctors are not taking any new Medicaid patients as lower reimbursement rates make it cost-prohibitive.”


Let’s gauge physicians who take no new Medicaid patients, then program payments.

A Campbell aide, Curtis Buckley, told us by email that Campbell based her 7-in-10 statistic on a 2012 Texas Medical Association survey indicating that 44 percent of Texas doctors were declining new Medicaid patients, 26 percent limited such patients and 31 percent accepted new Medicaid patients without restriction.

There’s fresher data. The group’s 2016 survey, which we fielded from TMA spokesman Steve Levine, found 38 percent of physicians accepting no new Medicaid patients, 21 percent limiting such patients and 41 percent accepting new Medicaid patients without restriction.

Both surveys, that is, indicated about 4 in 10 Texas practices not accepting new Medicaid patients.

Buckley, Campbell’s aide, also pointed out a 2014 study by Merritt Hawkins, a health-focused consulting firm, testing Medicaid acceptance rates in Dallas and Houston.

His nudge led us to find another Merritt Hawkins study, released just before Campbell made her claim. It indicates that nationally, as of early 2017, 53 percent of 1,414 contacted physician practices in major metro areas were accepting Medicaid, with 60 percent of 494 practices in midsized metro areas doing so.

Acceptance rates were lower, though, in cities where different kinds of practices (cardiology, dermatology, obstetrics-gynecology, orthopedic surgery and family medicine) were queried by phone. On average, 17 percent of Dallas practices, 26 percent of Odessa practices and 37 percent of Houston practices reported accepting new Medicaid patients.

A Merritt Hawkins spokesman, Phil Miller, pointed us to yet another report, though its focus wasn’t on accepting “new” Medicaid patients. The 2016 national survey of 17,200 physicians conducted for the Physicians Foundation found 16 percent not seeing Medicaid patients, 20 percent limiting such patients and 64 percent accepting Medicaid patients. A chart showed that nearly 30 percent of Texas physicians did not accept Medicaid patients.

Otherwise, we heard back from Jeff Lancashire of the National Center for Health Statistics. He emailed us an excerpt from the 2015 National Electronic Health Records Survey indicating that 28.2 percent of primary care physicians weren’t accepting new Medicaid patients, with 71.6 percent accepting such patients — though Texas-specific results were yet to be posted, the center’s Corey Slavitt said.

Medicaid fees

Campbell’s aide, Buckley, said her reference to Medicaid fees tied to her professional background.

Buckley also pointed out a June 2016 analysis published by the TMA confirming that in Texas, “reimbursement amounts for the same procedures differ among payers, with public payers (Medicare and Medicaid) setting a much lower rate than” what private payers offer.

Our hunt for expertise led us to a March 5 report posted by the Washington-based Urban Institute indicating that last July, Medicaid fees paid to Texas physicians amounted, on average, to 65 percent of fees paid by federally funded Medicare; nationally, Medicaid fees averaged 72 percent of Medicare fees.

In Texas, the report says, Medicaid fees paid for primary care services in 2016 were 58 percent of Medicare fees; for obstetric services, 66 percent; and for other services, 85 percent.

Our ruling

Campbell said, “Seven out of ten doctors are not taking any new Medicaid patients as lower reimbursement rates make it cost-prohibitive.”

Texas Medicaid payment rates trail those for other kinds of insurance.

But the crux of this statement, the 7-in-10 statistic, lacks factual footing partly because it combines different answers to an outdated physician survey.

In contrast, a 2016 national survey indicated that about 2 in 10 physicians were not accepting Medicaid patients and about 6 in 10 accepted Medicaid patients. The same year, a Texas survey found about 4 in 10 doctors in the state not accepting new Medicaid patients. It’s worth noting, still, a 2017 study suggesting far more Texas specialists weren’t accepting new Medicaid patients.

We rate this claim Mostly False.

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Donna Campbell misses the mark on care for Medicaid patients –