Medicaid Increases the Number of Emergency Room Visits

January 5, 2014

Researchers conducting the Oregon Medicaid study released more results last week. It turns out that having Medicaid health insurance actually increases emergency room visits by 40 percent.

The Oregon study is the first randomized, controlled examination of the difference between having Medicaid (or any health insurance, for that matter) and no health insurance. It is based on a lottery that Oregon officials conducted in 2008 where 6,400 people were enrolled in Medicaid and another 5,800 people were eligible, but not enrolled because of limited funding for Medicaid. (Here)

One of the biggest arguments for the expansion of Medicaid in Obamacare is that it will decrease costly emergency room use. Unfortunately, but predictably, having Medicaid does not decrease the number of ER visits. Medicaid payments for providers are so low that primary care doctors can not pay their overhead with what Medicaid reimburses them. Consequently, access to primary care is a significant problem for our existing Medicaid patients and they are left to use ERs for this care.

Earlier published results of the Oregon study showed a subjective improvement in well-being and a protection from financial loss for people with Medicaid. There was no difference, however, in measurable parameters such as blood pressure, cholesterol and blood sugar control, nor did Medicaid have any impact on the incidence or control of obesity. These findings were confirmed in the latest report.

The study timeline is too short, so far, to show any difference in mortality. However, heart and stroke problems are still the leading cause of dealth in the U.S. and uncontrolled blood pressure, blood sugar (diabetes), cholesterol and obesity are big risk factors. Medicaid does not improve these risk factors and consequently will probably not improve overall mortality rates for people with Medicaid compared to people who have no health insurance. This lack of risk-factor improvement, coupled with the increase in emergency room usage, confirm that Medicaid must be reformed


Medicaid providers

I believe that the reason ER visits have increased by Medicaid patients is because physicians are not required to accept a percentage of Medicaid patients. Therefore this is where the reform needs to be applied. Being able to see a physician is what will enable Medicaid patients to control blood sugar, cholesterol etc. Therefore Medicaid does indeed have the ablility to improve overall mortality rates for Medicaid patients. Why are not physicians required to accept a small percentage of Medicaid patients; especially mentally ill individuals who have a known shorter lifespan due to having medical and mental healthcare withheld.