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The Oregon Health Insurance Experiment is a landmark, randomized study of the effect of expanding public health insurance on the health care use, health outcomes, financial strain, and well-being of low-income adults.
We supplemented these data with emergency department records for an 18-month period following the lottery.
Emergency department visits overall ◦Medicaid increased the probability of using the emergency department by 7 percentage points (an increase of about 20 percent, relative to a base of 34.5 percent).
◦Medicaid increased the number of emergency department visits over the 18-month period by about 40 percent (0.41 visits, relative to a base of 1.02).
Does Expanding Health Care Coverage Reduce ER Visits?
On the contrary: A new study suggests it increases visits to the emergency room—significantly.
A few weeks ago, I was asked to write a comment to accompany a study released Thursday in Science, which shows that Medicaid access increases emergency room visits by more than 40 percent. To get a sense of how medical practitioners would respond to the findings, I asked my wife, a primary-care physician at Bellevue Hospital, whether she thought Medicaid would increase or decrease ER use by the kinds of low-income individuals who constitute her patient population. Her reaction: “I refer people to the emergency room all the time. Of course it’ll go up.”
Even if my wife and her fellow primary-care providers aren’t shocked to find their everyday experience validated by a large-scale experiment, many others will be. Public officials from Health and Human Services Secretary Kathleen Sebelius to state governors in Michigan and Ohio have cited a reduction in traffic to overstressed emergency departments as a rationale for insurance expansion. They’d do well to change their talking points.