Emergency Room Crowding Decreases After The Formerly Uninsured Get Insurance, UCLA Study Finds
A new study out of University of California, Los Angeles (UCLA) found that when people enrolled in low-cost Obamacare health plans, emergency room visits increased significantly — but then decreased dramatically within a year.
Though it may seem like more enrollments could lead to emergency room crowding, the study’s results signify what is ultimately a good thing. Once patients who were previously uninsured got insurance for the first time, they took advantage of it by going to the ER for disorders that had previously been left untreated — but after a year, ER visits dropped significantly because these same people had less of a reason to rush to the ER.
The researchers who worked on the study discovered that patients without medical care or health coverage prior to enrolling in Obamacare went to the emergency room at a rate of 600 visits per 1,000 enrollees in the first three months after being insured. People who already had insurance, meanwhile, visited the ER at a rate in the hundreds — much less often. In other words, uninsured patients were likely to keep chronic disorders hanging without going to see the doctor for treatment; once they got insurance for the first time, however, they were likely to rush to the ER to get treated immediately. People who have insurance and see their doctor regularly can take more preventive measures to avoid unnecessary ER visits.
“One major concern about the [Affordable Care Act] Medicaid expansion is that a high level of need among the newly eligible may lead to runaway costs, which could overwhelm state budgets when federal subsidies no longer cover 100 percent of the expansion population’s costs in 2017,” the authors write. “Although cost increases as a result of the newly eligible are likely, an even more important question is whether these increases will be temporary or permanent. Evidence … suggests that cost and utilization increases among newly eligible Medicaid beneficiaries will be mostly temporary.” The authors note that “early and significant investments in infrastructure” as well as improved care delivery can address the demand for health care services among previously uninsured people.
Though L.A. County emergency room visits increased by one percent in the first three months of expanded Obamacare coverage, they decreased after a year, ultimately lowering the overall crowding in emergency rooms. Dr. Gerald Kominski, a UCLA professor and author of the study, says the research should be encouraging for states who are aiming to expand their Medicaid program because their concerns that it will bankrupt them are “completely unfounded.”
“We were hoping that this would be the case,” Kominski told KQED News, “because we think that that’s what access to care does for low-income individuals… that there’s an additional increase in demand for services and that demand, or utilization, drops off pretty rapidly.”
But others aren’t so sure that Obamacare will be the answer to crowded emergency rooms. In another recent study, researchers from UC San Francisco found that enrollment in health care led to an increase in emergency room visits, and there was no way of telling if Obamacare could eventually lead to the decrease of visits over time. “There’s multiple things going on,” Dr. Renee Hsia, associate professor of emergency medicine at UCSF, told the Los Angeles Times. “It’s not going to be a one-stop solution.”