Obamacare Expanders’ Emergency Room Claims: Still False

Supporters of the Affordable Care Act’s Medicaid expansion have claimed for many years that implementing Obamacare would reduce emergency room visits. In a press release distributed on New Year’s Eve 2013, Missouri Gov. Jay Nixon suggested that by expanding Medicaid fewer people would show up to emergency rooms.

Tomorrow, businesses in these states [that expand Medicaid] will have a significant competitive advantage—because as more people get health coverage, fewer people show up in emergency rooms, putting downward pressure on private health premiums. [Emphasis mine]

We’ve noted before that this isn’t true, and news released yesterday from the American College of Emergency Physicians confirms this yet again.

A survey of 2,098 emergency-room doctors conducted in March showed about three-quarters said visits had risen since January 2014. That was a significant uptick from a year earlier, when less than half of doctors surveyed reported an increase. The survey by the American College of Emergency Physicians is scheduled to be published Monday.

Medicaid recipients newly insured under the health law are struggling to get appointments or find doctors who will accept their coverage, and consequently wind up in the ER, ACEP said. Volume might also be increasing due to hospital and emergency-department closures—a long-standing trend.

“There was a grand theory the law would reduce ER visits,” said Dr. Howard Mell, a spokesman for ACEP. “Well, guess what, it hasn’t happened. Visits are going up despite the ACA, and in a lot of cases because of it.” [Emphasis mine]

Obamacare didn’t fix what was wrong with Medicaid. It simply doubled-down on a broken status quo—adding beneficiaries to a limited and narrowing network better known for its terrible health outcomes and dysfunction than for its care. If we want to make health care for the neediest in this state better, then we have to actually reform the current Medicaid program, not repackage Obamacare’s expansion and overlay it onto actual reform proposals.

Missouri needs Medicaid reform, both for beneficiaries and for taxpayers. Expanding Obamacare doesn’t get us there.