Study: ACA Could Worsen Shortage of Safety-Net Providers in Calif.

Full implementation of the Affordable Care Act could further exacerbate a shortage of safety-net health care providers in California, according to a study by California State University-Monterey Bay, HealthyCal reports (Griffy, HealthyCal, 7/18).

Background

Only 16 of the state's 58 counties have the supply of physicians recommended by the federal government.

In addition, the Association of American Medical Colleges says that nearly 30% of California's doctors are nearing retirement age.

Meanwhile, the state is preparing to expand Medi-Cal and require most residents to have health insurance under the Affordable Care Act. Medi-Cal is California's Medicaid program (California Healthline, 5/29).

Study Details

Researchers from CSUMB examined U.S. Census data and surveys of health care providers to estimate the number of new physicians needed to care for individuals at safety-net clinics in Monterey County once the ACA takes full effect.

The researchers assumed that each provider would care for about 2,000 patients.

Findings

The study found that there currently are 36 full-time physicians serving about 85,000 patients at safety-net facilities in Monterey County, meaning that each doctor cares for 2,349 Medi-Cal beneficiaries or uninsured patients.

Researchers estimated that up to 55,000 state residents could gain insurance under the ACA. According to the findings, each safety-net clinic in Monterey County would need 10 more doctors to provide care for patients gaining coverage under the ACA.

Difficulties of Making Projections

However, Ignacio Navarro -- a researcher involved in the study and assistant professor at CSUMB -- said, "There are some unknowns in forecasting."

He said, "How many of these new individuals will seek services in the clinics? No one knows exactly the proportion who will enroll and seek services, even though there are efforts right now to try to enroll as many people as possible."

According to HealthyCal, the study's assumptions about past enrollment behaviors could "prove useless" if campaigns to get more healthy individuals to obtain insurance are successful. If every eligible individual signed up for coverage, Monterey County would need at least 25 additional providers at each safety-net clinic (HealthyCal, 7/18).