Medicaid co-pays are simply bad medicine

THE NEW Mexico Human Services Department is proposing co-pays for certain Medicaid recipients when they receive health care services. As family physicians, we care for many patients with Medicaid in our offices and clinics around the state. We see this proposal as a barrier to good health care.

It has been shown that even when small co-pays are charged, patients with limited incomes will avoid necessary care. This leads to delays in diagnosis and treatment. When an ailment becomes worse due to delays in seeking care, patients usually end up in an emergency room, where care is much more expensive.

Ironically, this increased cost is then passed along to the Medicaid program. If the care had been provided at an earlier stage in a primary care office, those costs would have been much lower due, in part, to the value of a doctor-patient relationship established over time. Helping patients manage their health conditions in a continuous relationship with their doctor makes good health care policy, better quality care for the patient at lower cost to the patient and to the state of New Mexico. Co-pays, however, push us in the opposite direction.

Beyond that, when patients do come to our offices for care and are faced with copays they can’t afford, the office or clinic is left with an unpaid charge. It has been estimated that only $1 of every $14 is collectible in this situation. That amounts to a tax on the provider, making it harder for doctors to stay in business when they accept Medicaid patients.

We oppose instituting co-pays for Medicaid patients because they add additional barriers to our patients and lead to late, expensive and lower-quality care, which will drive up costs for patients, the state and for doctors who provide the care.