Having US Medicaid insurance may increase ER use:Study
CHICAGO, (Reuters) - Expanding access to Medicaid, amajor plank of President Barack Obama's health reform law, could increase emergency room visits by people on the health care program for the poor rather than decrease them, results of a study published on Thursday suggest.
A unique experiment in Oregon in which residents were randomly given Medicaid insurance cards, showed their visits tothe emergency room increased by 40 percent, a sobering statisticas many states face an influx of new Medicaid patients under the new law.
The study, published in the journal Science, suggests simply providing insurance coverage to low-income Americans will not beenough to curb their use of emergency rooms, which for many hasbeen the only place they can turn when health problems becomeacute and more costly to treat.
The research, based on records from thousands of emergencyroom visits, did not shed light on why ER visits increased.
Opponents of the Affordable Care Act seized on the study as evidence that the law will lead to higher costs for the healthcare system rather than save money over time.
The law, popularly known as Obama care, allows states to expand Medic aid to millions more of their residents. Coverage under the new criteria, which have been adopted in some form by 26 states, took effect on Jan. 1.
The Obama administration estimated in September that Medicaid enrollment will increase by 8.7 million in 2014, nearly all as a result of the Obamacare expansion.
The findings seem to counter Obama's assurances that his medical coverage over haul will ease pressure on emergency roomsand suggest ER spending could increase by half a billion dollars per year, said Michael Cannon, a healthcare expert at the libertarian Cato Institute in Washington.
Cannon based that estimate on the study authors' estimate that Medicaid increases annual spending in the emergency department by about $120 per covered individual.
Dr David Ansell, chief medical officer of Rush University Medical Center, which serves low-income patients from Chicago'sWest and South sides, said he was not surprised by the findings,noting that the uninsured have been “trained” to turn to the emergency department for care.
“We will change behavior when we change people's experiences. It will take time,” he said.
Some proponents of Medicaid expansion say the coverage will encourage people to first seek care with primary care doctors,who can help identify health problems with preventive screeningsand manage chronic ailments, reducing the need for high-costcare in an emergency department.
“What we find is that Medicaid increases emergencydepartment use,” said study lead author Sarah Taubman of the National Bureau of Economic Research, a non-partisan research group based in Cambridge, Massachusetts.
To study this issue, Taubman and colleagues turned to the Oregon Health Insurance Experiment, a study in which the state randomly picked a group of lowincome adults to receive insurance coverage under its Medicaid program.