The study, published in the journal Science, compared thousands of low-income people in the Portland area who were randomly selected in a 2008 lottery to get Medicaid coverage with people who entered the lottery but remained uninsured. Those who gained coverage made 40 percent more visits to the emergency room than their uninsured counterparts during their first 18 months with insurance.
In the current Medicaid system, doctors and clinics are in critically short supply. The Affordable Care Act basically did nothing to address this issue. It did not incentivize participation in the Medicaid program through a better reimbursement system, nor did it cut the enormous amount of red tape that participants must suffer through. Instead, it dumped millions into the program with no real thought as to how the program would accommodate them.
It probably only took a few tries for the people in Oregon to understand how short of medical resources the Medicaid system is. It means literally waiting months for an initial appointment with your primary care physician, and maybe at best a 50-50 chance of getting in to see him if you are sick with a routine illness like a cold or the flu. And if you are accustomed to using the ER, why wouldn’t you just choose to go there again? After all, you are no longer a charity patient – you are “covered.”
The “model” program for Obamacare, which is Romneycare in Massachusetts, also studied emergency room access after the implementation of the program. They published their results in 2011, and you’ll never guess what they discovered – “Massachusetts health reform didn’t cut ER visits.” In fact, it slightly increased them.
You’ve also got to love the link-embedded headline from yesterday’s New York Times story – “Access to Health Care May Increase ER Visits, Study Suggests.” When will people learn that simply being enrolled in Medicaid is NOT the same thing as “access to health care?”
And when will they learn that if you give people access to something “for free,” people will always use more of it?