When pediatrician Dr. Rosemary Fernandez Stein and her husband set out to start up a pediatric group in 1999, their goal was to provide outstanding medical service to underserved populations in Burlington, N.C.—primarily Hispanic patients who often had limited access to care.
Back then, some of the biggest concerns were keeping overhead and health care costs low, malpractice insurance, and having enough supplies for patient use. Today, Obamacare is high on Dr. Stein’s mind.
“I keep worrying about what will happen to our long-term disabled patients who are in pediatrics,” says Dr. Stein, who co-owns International Family Clinic. With an influx of 15 million Americans expected to enroll in Medicaid through the health law, Dr. Stein worries available resources could be limited for her patients.
On an average day, the practice sees about 75 to 80 patients, with 75 percent of them receiving their health coverage from Medicaid, the federal-state public health program. “It could limit the options I have for a patient with Down syndrome that also has terrible heart defects.”
Another big stressor is the diminishing choices doctors have when serving Medicaid patients. “With Medicaid and many insurers we accept, we have to get authorization for using medication that is stronger or better,” Stein says. “This requirement for extra work in filling out paperwork, doing it online, or calling an authorization center is going to push a lot of doctors to change their habits. And I don’t think that will always be in the best interest of the patients.”
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