For Many New Medicaid Enrollees, Care Is Hard to Find, Report Says

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WASHINGTON — Enrollment in Medicaid is surging as a result of the Affordable Care Act, but the Obama administration and state officials have done little to ensure that new beneficiaries have access to doctors after they get their Medicaid cards, federal investigators say in a new report.

The report, to be issued this week by the inspector general at the Department of Health and Human Services, says state standards for access to care vary widely and are rarely enforced. As a result, it says, Medicaid patients often find that they must wait for months or travel long distances to see a doctor.

The inspector general, Daniel R. Levinson, said federal and state officials must do more to protect beneficiaries’ access to care, in view of the program’s rapid growth. Just since October, the administration says, eight million people with low incomes have enrolled. By 2016, the Congressional Budget Office estimates, one in four Americans will be on Medicaid at some time during the year.

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The federal government “uses a checklist to confirm that states have access standards,” but does not analyze whether the standards ensure access to care, Mr. Levinson said. Federal officials, he said, view the setting of standards as “primarily a state responsibility.”

In assessing whether health plans have enough doctors, states typically rely on information supplied by insurers, Mr. Levinson said, but “this information is often inaccurate or out of date.” Some doctors are no longer in health plan networks. Some are not taking new Medicaid patients. Some were never at the address listed in the insurer’s directory of providers.

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