The New York Times reports on the expected ill effect of expiration this week of federal support of payments for primary care under Medicaid commensurate with Medicare. President Obama wanted to continue the payments another year, but Congress didn’t go along and the Republican majority of the new Congress seems even less likely.

The impact will vary by state, but a study by the Urban Institute, a nonpartisan research organization, estimates that doctors who have been receiving the enhanced payments will see their fees for primary care cut by 43 percent, on average.

That report estimates cuts in Arkansas in the range of 25 to 35 percent.


Dr. David A. Fleming, the president of the American College of Physicians, which represents specialists in internal medicine, said some patients would have less access to care after the cuts. It would make no sense to reduce Medicaid payments “at a time when the population enrolled in Medicaid is surging,” he said.