More evidence expanding Medicaid increases emergency room visits
When a provocative study showed that expanding Medicaid increased trips to the emergency room two years ago, some supporters of health reform were disappointed and hoped that it would prove to be only a temporary spike.
After all, the findings -- based on Oregon's expansion of Medicaid in 2008 -- challenged the key assumption that low-income people who gained insurance coverage would go to primary care doctors instead of relying on emergency rooms. Critics of the law pointed to the study as evidence that the states that expanded Medicaid under the Affordable Care Act were making a mistake.
The surge in emergency room visits wasn't temporary, at two years and counting, according to a new study in the New England Journal of Medicine, led by researchers at the Massachusetts Institute of Technology.According to the new study, people who gained Medicaid visited the emergency room about 65 percent more often than individuals who did not gain Medicaid in the first six months -- and the trend continued out to two years. The estimates of increased emergency department use at 12 months, 18 months and 24 months are "similar and, for the most part, statistically indistinguishable from each other," the authors wrote.
People covered by Medicaid were more likely to both see a physician at a regular office visit and also go to the emergency room, casting doubt on the idea that people were using health coverage to shift their health care to a primary care doctor.