We’ve made great strides in health care access in Spokane, and across Washington. Over the last year, more than 44,000 additional people in Spokane County gained insurance coverage through Medicaid. They can now see a provider when they are ill, and get routine and preventive care, particularly important for patients with chronic conditions like asthma or diabetes.

In turn, better preventive and primary care access translates into savings for the state. Uninsured patients often delay basic care and end up in the emergency room. This is an expensive way to provide medical care. It is clear that not having access to primary care services delays needed care and raises the risk of serious illness. Access to quality primary care is shown to reduce preventable emergency room visits.

But we have yet to make this loop complete. At a time of increased demand for primary care services, we are asking physicians to accept Medicaid payments that are below the level needed to sustain their practices. With the current reimbursement rates, providers actually lose money when seeing a Medicaid patient.

It’s a situation that makes many providers unable to accept new Medicaid patients. It forces primary care providers to choose between accepting new Medicaid patients or keeping their doors open. In attempt to remedy this, the federal government did raise Medicaid rates for primary care services, but that temporary increase expired in December.

It’s now up to the Washington Legislature to maintain the fair reimbursement rate for primary care providers to close the loop. It’s good for patients accessing care, it’s good for providers trying to keep doors open to all, and it makes financial sense for the state.

Recent studies have shown that fair Medicaid rates do improve access to primary care. A study looked at the effect of the temporary enhanced Medicaid payment rates on primary care access in 10 states (not including Washington). In states with enhanced rates, the availability of primary care appointments for new patients increased by 7.7 percentage points. The states with the largest increases in Medicaid appointment availability also tended to be the states with the largest increases in Medicaid reimbursements.

A recent Washington survey also showed that just over one-third of primary care physicians in smaller practices were willing to accept new or continue providing care for current Medicaid patients as a result of the Medicaid payment increase.

Primary care providers are committed to caring for our patients, but Medicaid rates below the cost to provide care are an unfair burden to providers and an unsustainable situation for many practices. Without an extension of the Medicaid increases for primary care providers, primary care physicians in Washington are facing a 36.3 percent rate cut.

We are asking our local legislators to support primary care services for our Medicaid patients. We need them to complete the circle and support these patients when budget negotiations get tough. It makes good financial sense and thousands of Spokane County residents depend on it to get the care they need.