Medicaid-LogoMost doctors in private practice lose money on Medicaid patients, because the program pays less than commercial health plans or Medicare, the federal insurance program for Americans over 65. Many physicians already don’t accept Medicaid, and millions of new enrollees clamoring for appointments will strain those who do.

About 46 percent of physicians accept Medicaid, according to a 15-city survey last year by staffing firm Merritt Hawkins. That’s down about 10 percent from four years before. To encourage primary-care doctors to take Medicaid patients, the Affordable Care Act has temporarily increased the program’s payments to doctors, matching Medicare’s higher rates through 2014. But the boost doesn’t apply to specialists such as cardiologists and oncologists.

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