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Number of Residents Without Regular Doctor Varies by State

By Marissa Evans, CQ Roll Call

May 6, 2016 -- Patients are gaining more access to health insurance under the federal health law, but often haven't found the right provider or been diligent about making appointments to see them, according to a survey by the Centers for Disease Control and Prevention.

Nevada had the most people who did not have a usual place of medical care at 26.7 percent, according to the survey released Thursday. Idaho, Oregon, Texas, and Wyoming rounded out the top five states with the highest rates of people without a usual place to receive medical care. Vermont had the lowest rate of residents without a consistent provider at 2.8 percent of residents. Delaware, Hawaii, Massachusetts, and Wisconsin were also part of the five states with the least number of people without a provider.

"Many factors likely influence rates of health care utilization, and rates may change as the length of time since Affordable Care Act implementation increases," according to the report. "Although it is difficult to determine the complex reasons for differences in state health care utilization rates, these estimates can serve as a baseline for these measures."

Just because patients had a provider does not mean they saw them. The report found that in 2014, 34 percent of patients had not seen or talked to a general doctor in the last year. About 48.1 percent of Montanans did not see their doctor in the previous year. South Dakota, Nevada, New Mexico, and South Carolina residents also were among the least likely to visit a doctor.

The study found Medicaid expansion influenced the number of people who had access to care and used it but the percentage variations were minimal. Under the federal law, states can allow people with incomes up to 138 percent of the federal poverty line to be part of Medicaid. The federal government picks up 100 percent of the cost through 2016. Starting in 2017, states that expanded will have to start chipping in a portion of the cost. States must cover 10 percent of the cost by 2020. Thirty states and the District of Columbia are participating in the expansion.

In 2014, among residents living in states that had not expanded the Medicaid program, 35 percent did not see or talk to a primary care doctor during the year, according to the report, compared to 33 percent of residents in states that had expanded. In addition, 18.2 percent of non-expansion state residents did not have a usual place of care, compared to 16.6 percent of those in states that expanded.

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