How many times have you heard a liberal say we need to get more of the uninsured on Medicaid to reduce the number of ER visits for care that could be performed by a primary doctor? Well, they’re wrong again. A study in Oregon that was just released found that not only were ER visits not reduced, they increased after people were enrolled in Medicaid.
President Obama pitched a version of this idea in a speech last September, arguing that emergency room visits by the uninsured represented a hidden tax on everyone else. “When uninsured people who can afford to get health insurance don’t, and then they get sick or they get hit by a car, and they show up at the emergency room, who do you think pays for that?” he asked.
But the best evidence has never really supported the hope that the law would reduce emergency room usage. That’s because much of the law’s expanded coverage comes via Medicaid, the jointly run federal-state program for the low income and disabled. And Medicaid beneficiaries tend to visit the emergency room more often than the uninsured.
A new study of Medicaid beneficiaries in Oregon makes a strong version of this case. The study, published today in the journal Science, finds that adult Medicaid beneficiaries rely on emergency rooms about 40 percent more than similar uninsured adults.
“When you cover the uninsured, emergency room use goes up by a large magnitude,” said Amy Finkelstein, a health economist at the Massachusetts Institute of Technology who served as a lead investigator on the study, in an MIT press statement accompanying the study.
There were no exceptions to the trend. “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,” said Finkelstein.
Read the whole thing. This law was never about reducing ER visits, or making health insurance more affordable, it’s always been about centralized control of our health care.