A study by Chapin White finds that "increasing Medicaid physician fees is more clearly associated with improvements in access," which is a polite way of saying that reducing fees is associated with declines in access. White also notes that "budgetary surpluses and shortfalls appear to be the main factors prompting states to change their Medicaid fees." White doesn't explicitly state what we all know: that state budgets are collapsing under the pressure of Medicaid's growth, and that PPACA's dramatic expansion of Medicaid will therefore ultimately force states to continue to reduce Medicaid fees. And reduced fees, White's study confirms, are correlated with poorer access to care.
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