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Medicaid recipients visit ER more than those without coverage

It’s always been the contention of the left that having medical insurance coverage would ensure the sick visit their primary care doctors instead of the emergency room, lowering the costs of medical care for everyone. New research suggests, however, “that adults who have their medical care covered by Medicaid use emergency rooms 40% more than adults in similar situations who do not have health insurance.”



Information provided from a research study from the Massachusetts Institute of Technology (MIT) and the Harvard School of Public Health suggests that by analyzing two groups, one group with Medicaid coverage and one group without coverage in the state of Oregon, they were able to determine that the group with coverage had more ER visits. The study included reviewing a randomized controlled evaluation of Medicaid by analyzing emergency room records for around 25,000 individuals over 18 months.

What’s more interesting is that researchers determined that emergency room visits were 40% higher for those who had health insurance. This determination was consistent for all demographic groups, all medical conditions and for all different types of visits.

What does this mean? According to researchers, having Medicaid benefits does not decrease the number of times that any population group with any condition will go to the ER. This should be a cautionary warning to the states who have decided to expand Medicaid for the specific purpose of decreasing emergency room use. According to this study, this goal is unlikely to be reached.

Can this study be extrapolated to the entire United States? Researchers say yes. In fact, given the introduction of the Affordable Care Act, many states have increased Medicaid to similar levels as those done within the Oregon study.

What is Medicaid?


 

Medicaid is a governmental insurance program which offers medical health services to children, pregnant women, the elderly, the disabled and families with limited income and resources. Under the Affordable Care Act Medicaid was expanded in some states.

Why does Medicaid expansion increase visits to the Emergency Room?


 

Medicaid expansion is likely to increase the number of emergency room visits even if the patient has the ability to visit a primary care doctor because of the significant decrease in out of pocket costs for Medicaid recipients.

It should not be surprising that if the cost of a service is lowered consumers are more likely to purchase the product, leading to increases in the use of emergency services. For example, in my family with a $10,000 deductible, if we visit the ER for a minor injury we can expect to pay $10,000. I have told all of my children that no ambulance should be called unless we have a life-threatening emergency.

If your deductible is $500 or less, it makes sense that your consideration for visiting the emergency room is much lower.

So should we expand Medicaid? Many are willing to debate the merits of expanding the Medicaid program, but suggesting that it will reduce emergency room visits may not be a good argument for expansion.