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Study: Medicaid Expansion Increases ER Visits

A study by researchers at Harvard University shows people who are given access to Medicaid coverage get more emergency care.
Posted at 8:13 PM, Jan 02, 2014

With the new year came the option for states to expand Medicaid under the Affordable Care Act. But a study released Thursday by researchers at Harvard University shows the expansion could actually increase emergency room visits — something that wasn't expected to happen.  

In 2008, the state of Oregon gave Medicaid coverage to a select number of random residents using a lottery. It was called the Oregon Health Insurance Experiment. (Via Oregon

It was the first study of its kind, used to measure the effects of expanding public health insurance. (Via National Bureau of Economic Research

Proponents hoped the expansion would make it easier for patients to see primary care providers, getting preventative care and cutting down on costly ER visits.

But according to the study it did the opposite — increasing emergency visits by 40 percent among those Oregonians who received the coverage. (Via Science

A health economist at the Massachusetts Institute of Technology told The Washington Post, "I would view it as part of a broader set of evidence that covering people with health insurance doesn't save money. That was sometimes a misleading motivator for the Affordable Care Act. The law isn't designed to save money. It's designed to improve health, and that's going to cost money."

But regardless of what the act is designed to do, a writer for Forbes calls the findings "a very big deal" and a broken promise from the Obama administration. 

OBAMA: "...prevention and wellness, to make sure that people are getting the care they need and the checkups they need and the screenings they need before they get sick -- which will save all of us money and reduce pressures on emergency rooms." (Via The White House

But the study's authors caution not to jump the gun on the results — there's a chance they could shift over time. The study only included the first 18 months after people received coverage and the habit of visiting the ER could initially be hard to shake. 

One researcher said, “How to use a plan and when to seek emergency department care involves a learning curve that doesn’t happen overnight.” (Via The New York Times

As for the rest of the country, 25 states and Washington D.C. opted to expand Medicaid through the Affordable Care Act.