Better-off areas are bulk billed least, and the gap has doubled
Where people are least disadvantaged, fewer GP visits are bulk billed. Since 2021 that gap has grown from about 10 points to about 22.
Every state is up on a year ago
Figure 1.Share of GP visits bulk billed, by state, a year apart
Source: Medicare quarterly statistics, state and territory.
The better off an area, the less it is bulk billed
Figure 2.Share of GP visits bulk billed, by how disadvantaged each area is
Areas are ranked from most to least disadvantaged on the ABS Index of Relative Socio-economic Disadvantage (SEIFA 2021) and split into fifths. It describes each area as a whole, not individual patients, and shows an association, not a cause. Sources: ABS; Medicare quarterly statistics, SA3 summary.
The gap between better-off and disadvantaged areas has doubled
Figure 3.Share of GP visits bulk billed in the middle area of each fifth, by quarter
Areas are grouped into fifths by the ABS Index of Relative Socio-economic Disadvantage (SEIFA 2021), as in Figure 2; each line is the median area in its fifth. Numbered markers are the November 2023 and November 2025 incentive changes. Sources: ABS; Medicare quarterly statistics, SA3 summary.
What the numbers suggest
Bulk billing has recovered unevenly. The most disadvantaged areas are back near their 2021 rate; the least disadvantaged are still about 13 points below theirs. Since November 2025 the incentive has applied to every Medicare card holder. It lifted every fifth of areas by a similar amount, about 7 points, so it raised bulk billing everywhere without narrowing the gap between them.
That gap is not, on its own, an equity failure. Bulk billing remains highest where need is greatest, and most incentive payments flow to the areas that bulk bill most. The concern is narrower. The gap fee is much the same everywhere, about $60 for the middle area in each fifth; what differs is how often people pay it. Averaged over every visit, a GP visit cost patients about $19 in the least disadvantaged fifth of areas, against about $5 in the most disadvantaged. Better-off areas are not made up only of better-off people: students, renters and low-income workers live there too. In 2024–25, 8% of Australians said cost was a reason they delayed or did not see a GP when they needed to. Area figures cannot show who in these areas is paying, or who is staying away.
There are three broad options:
- Wait and review. The universal incentive is less than a year old, and practices are still joining. Judge it on a full year of data.
- Target the incentive. Pay more where bulk billing is lowest. This could narrow the gap, but it adds complexity and would reward practices that were slowest to change.
- Make fees visible. Require practices to show their gap fee before booking, so patients can choose without needing a higher subsidy.
Before choosing, the first step is to measure the gap by person, not by area. Linked national data that joins Medicare claims with Census information on income could show whether lower-income people in low-bulk-billing areas are paying gap fees or going without care. Any review of the incentive should report results by income and disadvantage, not only nationally.
Gap fees and cost per visit: median area in each fifth, Apr–Jun 2026, from Medicare quarterly statistics and ABS SEIFA 2021. Delayed care: ABS, Patient Experiences 2024–25.