OBAMACARE: Medicaid Expansion Drives Up Visits to Emergency Rooms

Some supporters of President Barack Obama's health-care overhaul say that putting uninsured Americans on Medicaid will reduce costly emergency-room visits by giving them more access to care in other settings. 

But a new study found the reverse: A group of 10,000 low-income Oregon residents who recently obtained Medicaid coverage visited ERs 40% more often than those without insurance. 

The new Medicaid recipients used ERs more often for all kinds of health issues, including problems that could have been treated in doctors' offices during business hours, according to the study published Thursday in the journal Science. Earlier studies had found the same patients used more of other medical services as well.

"Now we know—the hope that Medicaid will save money turns out not to be correct, at least in the first two years," said Amy Finkelstein, a Massachusetts Institute of Technology economist and a principal investigator of the study. 

On average, the Medicaid recipients visited ERs in 12 Portland-area hospitals 1.4 times during an 18-month period, compared with 1.02 visits for the control group without insurance. Using $435 as the average cost of an ER visit, the researchers calculated that Medicaid increased annual ER spending by $120 a covered person. Hospitals often end up footing the bill for uninsured patients.

States are sharply divided by Medicaid expansion, the one part of the 2010 health-care law that the Supreme Court ruled optional in 2012. To date, 25 states and the District of Columbia have accepted the Obama administration's offer to finance extending the Medicaid program to anyone earning less than 138% of the federal poverty level through 2016, and to finance 90% of the costs thereafter. 

Other states, mostly led by Republican governors, have declined the offer, citing their opposition to the health-care overhaul and cost concerns.

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