Does more coverage actually equate to more care? That's the question I was posed with while writing a story about a survey from the Association of American Physicians and Surgeons (AAPS; Tuscon, Arizona) concerning the upcoming Medicaid expansion.

The Patient Protection and Affordable Care Act calls for a nationwide expansion of Medicaid eligibility, set to begin in 2014. As the law was written, nearly all U.S. citizens under 65 with family incomes up to 133% of the federal poverty level (FPL) ($30,675 for a family of four in 2012) will now qualify for Medicaid.

During an interview with Jane Orient, MD, executive director of AAPS - she pointed out something so simplistic, something so thought provoking - but also something that gets overlooked in the discussion of expansion.

"Coverage just means you have an insurance card in your pocket. Care means that you actually get what you need," she said.

The AAPS survey painted an intriguing picture. According the survey of AAPS members, about 47% of respondents think that it is more difficult for a Medicaid patient, compared with an uninsured patient, to get an appointment with a primary-care physician. Only 26% thought that the uninsured had more difficulty. For specialist appointments, 44% thought uninsured patients were better off, and 32% thought Medicaid patients were better off. Only 2% thought that Medicaid patients had "no problem" getting an appointment with a specialist. Of the 166 respondents, 96 were physician specialists, 63 primary physicians, and 7 emergency physicians.

The red tape and frustration of navigating through the system is a huge turn off for doctors according to AAPS and there even seemed to be a preference to treating uninsured patients that could make payment arrangements to the doctors instead of treating those Medicaid patients.

It will be interesting to see how this question of whether more coverage equals more care, since many have touted the expansion to provide more opportunities med-tech and the healthcare sector as a whole. Time will tell.