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Medicaid Expansion May Boost ER Visits

Posted in Politics, Public Health

A recent article published by HealthDay News on MedlinePlus, a service of the US National Library of Medicine, purports that “the expansion of Medicaid … could lead to more use of emergency departments instead of less”.

This article cites new research that found Oregon users of Medicaid, “the publicly funded health insurance program for the poor — are 40 percent more likely to use emergency rooms than people with no insurance.”

Amy Finkelstein, an MIT professor and an author of that study states, “‘When you cover the uninsured, emergency room use goes up by a large magnitude’” and remarks “‘In no case were we able to find any subpopulations, or type of conditions, for which Medicaid caused a significant decrease in emergency department use.’”

That study also found that it is common for Medicaid users to seek emergency room care for conditions that “might be more easily treated in a doctor’s office.”

Here are some of the issues: people using Medicaid often work several jobs and thus are not available to see primary care physicians during normal operating hours.  Next, a point made by Julie Rovner of NPR, citing the “director of state policy and programs for the National Association of Medicaid Directors,” Kathleen Nolan, is that “Because Medicaid recipients are by definition low income, Medicaid doesn’t use higher patient payments to deter emergency room use like many private insurers do”.

Rovner cites Nolan, stating “the key to getting inappropriate costs down for all patients, she says, is educating people about where they should go when it’s not an emergency.”  I agree.