That out-of-pocket cost was reduced to zero after Washington officials moved to change the rules that had previously excluded naturopaths from the health insurance program for low-income patients.
"We were ecstatic," said Lewis, an office manager for an automotive body shop who lives in Sultan, Washington, and is due to have her second child in August. She said that she and her husband's combined salary is at a threshold where they don't qualify for Medicaid, but their 16-month-old son does qualify. "We don't have to stress about setting aside that money for the budget."
Naturopathic doctors are licensed in more than a dozen states, including Washington, but only three have allowed them to be part of the Medicaid system. When naturopaths were added to the list of providers who can receive Medicaid reimbursements, Washington joined Vermont and Oregon.
As states that expanded eligibility under the Affordable Care Act see the number of newly insured people on Medicaid steadily increase, naturopath groups say they can help address nationwide concerns about doctor shortages.
"The profession is still too small to entirely fill that gap of primary care providers, but we're one of the answers," said Jud Richland, CEO of the American Association of Naturopathic Physicians.
Naturopathic medicine focuses on prevention and overall health primarily through the use of natural therapies, though naturopathic doctors in Washington state can write prescriptions for many traditional medications, like antibiotics, as well.
Washington Association of Naturopathic Physicians executive director Robert May said that there are more than 800 licensed naturopathic doctors in Washington state, though he said there's no data yet on how many have decided to join Medicaid.
Only 17 states and the District of Columbia have licensed naturopathic doctors, the most recent state being Maryland earlier this year. And while the national group is making a licensing push in several more states this year, its other focus is on trying to get naturopaths covered under Medicare, the federal program for those 65 and older.
But, supporters said that Medicaid acceptance, while limited to so few states, is a good step.
"Certainly, it allows patients more choice," May said. "It allows a broader group of patients, who otherwise have never been likely to afford naturopathic care, to get it."
Washington state is among 26 states that have expanded eligibility to Medicaid to people who earn less than 138 percent of the federal poverty line, or about $16,104 a year for a single adult. Previously there was no Medicaid program for nondisabled childless adults between the ages of 18 and 65.
The number of people enrolled for Medicaid in Washington state, previously at 1.2 million, has jumped by 450,000 adults since Oct. 1. About 300,000 of those enrollees were newly eligible for the program, while the rest were previously eligible but did not sign up until the new health exchange started up. Washington officials moved to change the rules excluding naturopaths from Medicaid last year.
Lewis and her family go to Snohomish Valley Holistic Medicine's Dr. Stacy Bowker, who is a Medicaid provider through the state, and is also credentialed through Molina Healthcare. Officials with the state Health Care Authority say that about 200 naturopaths are enrolled in Medicaid either through the state, or through the five Medicaid-managed care plans in the state.
Bowker said she's taken on eight to 10 new Medicaid patients since the start of the year.
"We definitely had an influx of calls from people with Medicaid because of the awareness that we are covered," Bowker said. "I've had some people who were really thrilled and really excited. They had been waiting for the day when they could see a naturopathic doctor, because they were frustrated with their options."