DALLAS The number of low-income patients eligible for Medicaid will swell under the health care bill President Obama is scheduled to sign into law on Tuesday. It will scoop up millions of new low-income patients into an already crowded program.

Nationwide, an additional 16 million people are going to be put in the program, said John Goodman of the National Center for Policy Analysis. But there's no increase in doctors or nurses or hospitals, so you have a lot more people fighting for the same supply of health care.

In Texas, two million more people will be eligible for Medicaid under the new federal law. That will almost double the state's rolls, said a spokeswoman for the state's Health and Human Services Commission.

But the problem is, Medicaid pays doctors about half of what private insurance pays and that's driving away many specialists.

Currently, only 38 percent of Dallas doctors treat Medicaid patients, according to a report last year by Irving-based Merritt Hawkins & Associates. Dallas ranked the lowest of 15 major cities surveyed.

Experts now predict the line for those few physicians still seeing Medicaid patients is about to grow.

When you have Medicaid paying a real low rate; Medicare, a slightly higher rate; and the private patient up here, well, these people down here [on Medicaid] are going to get discriminated against, Goodman said.

Federal health care reform takes full effect in 2014.

Besides expanding Medicaid, the new law mandates that all Americans be covered by health insurance. Violators will be fined one percent of their income.

Small businesses, the self-employed and unemployed can buy less expensive coverage.

Plus, families of four making less than $88,000 a year qualify for subsidies.

It's a long ways from being perfect, but it's a great start, said Rep. Eddie Bernice Johnson, (D) Dallas.

Experts worry that with so many more Medicaid patients and with fewer doctors seeing them, many will seek care in emergency rooms exacerbating a long-standing problem.


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