States who chose to expand Medicaid because of the Patient Protection and Affordable Care Act/Obamacare saw a surprising increase in Medicaid volume.
The bill was supposed to reduce emergency room visits, but instead, that rate tripled.
The Colorado Hospital Association said their national study “shows hospitals in states that chose to expand Medicaid under the Affordable Care Act saw significantly more Medicaid patients and a related reduction in self-pay and charity care cases; whereas, hospitals in states that chose not to expand Medicaid experienced no changes outside normal variation in Medicaid volume or self-pay and charity care cases.”
The study used data collected from the start of the Medicaid expansion on Jan. 2 to March 31, 2014. Medicaid volume increased by 29 percent in that short time period, based on data from 465 hospitals in 30 states. The increase did not occur in states who opted not to expand Medicaid.
Emergency room visits tripled in states who expanded Medicaid. The study noted, “Hospitals in states that chose to expand Medicaid under the Affordable Care Act (ACA) reported…three times the increase of emergency department (ED) visits than hospitals in non-expansion states in second-quarter 2014 compared to the same time last year.”
No information was given regarding nationalities or citizenship status for patients, but that information may not have been available from the federal government. In studies prior to passage of the PPACA, data showed the majority of the uninsured were more likely to be foreign-born noncitizens. About 15 percent of the uninsured were self-employed. Verification of eligibility has proven difficult for the federal government.
Until 2020 the federal government will pay for states’ Medicaid expansion. After that, states will begin to pay as well. That information was omitted from the majority of media coverage about expansion.
Patients who are new Medicaid enrollees were likely either self-pay or charity cases before the PPACA passed. Local communities absorbed the charity expense. Now costs for large metro areas will be shifted to mid-sized and small cities where it may be less expensive to care for the uninsured.
Whether Medicaid expansion leads to better health across the community is not known.
Nor did the study authors note how many emergency room visits resulted from trauma incurred in auto accidents or crimes.
Communities have traditionally handled healthcare matters locally. With the passage of the tax bill popularly called Obamacare, the federal government took control of healthcare across the nation.
Photo credit: Emergency Care (CDC/Bob Sanders)
(Filed by Kay B. Day/Nov. 6, 2014)