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How Obamacare Will Change The Emergency Room

How Obamacare Will Change The Emergency Room

obamacare-logo_fullThe concept behind the Affordable Care Act is a practical one, especially with 16.3 percent of the population running to the emergency department when sick. One goal of the program is to reduce the stress on emergency rooms by providing alternatives to uninsured individuals who use hospitals as primary care providers. Supplying them with health insurance should prevent unnecessary trips to the ER, in theory, at least. A recent study indicates that the new system might actually have a different effect.

Uninsured Statistics

The Pre-Obamacare statistics are staggering.

  • 49.9 million Americans without health insurance
  • 7.3 million children living in homes where there is no insurance. That is 9.8 percent of the children in this country.
  • 28.4 percent of the uninsured are between the ages of 25 to 34 with 18.4 percent under the age of 65

What this means for hospitals is more patients coming to the emergency department for basic health care. A child with a sore throat might sit for hours in an emergency room because his or her parents can’t afford anything else.

Enter Obamacare

Obamacare promises to allow every person in the country access to affordable health care. Supporters of Obama’s health care initiatives state that giving insurance to people who can’t afford it will better equip them to manage their health care. With primary care physicians affordable to them, unnecessary trips to the ER will drop dramatically.

When you look at it that way, it would seem that Obamacare has the potential to alleviate the pressure on hospitals and save the emergency care for those with life-threatening problems. A new study suggests that the rebound from the Affordable Care Act will be the opposite of what the Democrats have been promising, however.

Harvard University Study

Harvard University used the Medicaid program in Oregon to predict how Obamacare will affect the emergency department. One of the key features of the Affordable Health Care Act is the expansion of Medicaid. Through expansion, Medicaid doors open to individuals and families that previously didn’t qualify.

The initial intent of expansion was to force states to do some of the heavy lifting necessary to correct the health insurance imbalance. Many states choose not to participate in the expansion. Oregon was one of the states that opted to go along with the federal government. They changed their Medicaid system in 2008.

The Harvard study evaluated emergency room visits for those under the new Medicaid program. Harvard researchers followed the ER use of 25,000 Oregon adults on Medicaid. This randomized study tracked recipients during their first 18 months on the program. The report shows that gaining coverage through Medicaid actually increased visits to the emergency department by 40 percent. Many of the visits were for problems treatable in a primary-care environment.

There is a financial motive behind the surge, according to Any Finkelstein, an economist with MIT. People that avoided medical care in the past will now run to the emergency room for help because it doesn’t cost them anything. On top of that, through Medicaid, a trip to the ER carries no copays.

The reliability of this study is under challenge. Obamacare representative Tara McGuinnes explains the study really didn’t allow people time to adapt to the new system. Another research project looked at the long-term effects of Medicaid expansion in Massachusetts and found an 8 percent drop in trips to the emergency department. People who are used to running to the ER with every sniffle will need time to shift to a more efficient system that supports a primary doctor. Time will tell whether hospitals see benefits from the Obamacare system.



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