Thousands of Medicaid doctors are bracing for a tough start to 2015: a 42 percent pay cut.

The Affordable Care Act temporarily boosted payment rates for primary care doctors who see Medicaid patients in 2013 and 2014. The idea was to make sure doctors kept participating in Medicaid — which typically has low reimbursement rates — even as the program expanded to cover millions more Americans this year.

That earlier Obamacare pay raise was big, averaging out to a 73 percent increase for primary care doctors across the country. But it was also temporary, lasting only two years, and is set to run out on December 31. That means, beginning January 1, 2015, Medicaid doctors will earn less each time they see a patient — or, they could decide to pull out of the program altogether. Nobody is totally sure which way doctors will go.

Here’s a quick guide to why the raise happened, why it’s running out, and what it means for the future of Obamacare.

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