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Medicaid expansion has an unexpected result


One of the major arguments for Medicaid expansion was that poor people would be able to see doctors instead of going to the emergency room for care. ER treatment is driving up healthcare costs, proponents said. (Debatable.) Now a study published in Science finds that Medicaid does the opposite: It increase ER use, NPR reports.

Medicaid coverage increased ER use for all kinds of conditions, including those treatable in other medical settings, the study found. "This is exactly what policymakers hoped to avoid by giving people health insurance – including thehuge increase in Medicaid coverage coming as part of the Affordable Care Act," writes NPR.

The study is well-credentialed -- experts from the Harvard School of Public Health and Oregon Health Insurance Experiment issued the paper -- and the increase is substantial: 40 percent, reports NPR. 

The reasons for the study results didn't surprise those who work with Medicaid recipients. For the poor who often work multiple jobs with inflexible schedules, the ER is always open, while most doctor's offices and community clinics are closed during their before- or after-work hours. Using the primary care system can also be time-consuming, involving multiple visits and locations for tests or follow-up. Despite the long waits in the ER, it may be perceived as more convenient because it's a one-stop shop. And Medicaid doesn't try to discourage ER use with higher payments, the way insurance does, NPR writes. 

While the study population isn't necessarily representative of others across the country, Medicaid expansion critics and resistant states like Florida will find ample ammunition there to pan President Obama's healthcare reforms.   Read more.




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