Emergency Room Visits Up Under Obamacare-like Massachusetts Law

A recent study of Massachusetts emergency care departments may imply more crowding under Obamacare, according to its lead author.

President Obama and other advocates of Obamacare claimed that increased health insurance coverage will lead to a decreased need for emergency room care.

The study, appearing in the Annals of Emergency Care, found up to a 2.2 percent increase in the use of emergency department care in Massachusetts after the state enacted health care reform between 2006 and 2008.

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The findings raise concerns as the full implementation of Obamacare nears.

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“If our findings are consistent for the rest of the nation, our results would imply that other states should be prepared for equal or greater increases in [emergency department] utilization as a direct consequence of the insurance expansions made possible by the ACA,” the study’s lead author, Peter Smulowitz of the Beth Israel Deaconess Medical Center, told The Daily Caller News Foundation.

The study looked at 13.3 million visits to 69 acute care centers throughout Massachusetts between 2004 and 2009, both before and after the implementation of Romneycare — the state’s health insurance plan on which Obamacare is largely based(RELATED: Five reasons Romneycare doesn’t guarantee Obamacare’s success)

The finding of a 2.2 percent increase in the use of emergency department care undermines some of the claims made by both Obama and former Massachusetts Gov. Mitt Romney who said that an increase in insurance coverage would decrease reliance on more expensive emergency care by increasing access to primary care physicians.

“I think that it’s very important that we provide coverage for all people because if everybody’s got coverage, then they’re not going to the emergency room for treatment,” said Obama in 2009.

“One way our insurers and our state health programs will be able to provide care at a lower cost is by directing patients towards the most effective and efficient care,” wrote Romney in a 2004 op-ed. “A sore throat can be diagnosed and treated by a physician or at an emergency room, but the cost varies dramatically.”

In 2006, Massachusetts enacted Romney’s major health insurance expansion. The law included individual and employer mandates and other reforms to expand insurance coverage. The rates of the uninsured fell from 10 percent before the reform to just under two percent today.

Smulowitz and his fellow researchers also noted that Massachusetts may be better positioned than other states, indicating that emergency care use rates might be even higher as coverage expands in other states.

“Analyses are likely to underestimate the effect of health care reform nationally because of the baseline high rate of insurance coverage in Massachusetts,” reads the study.

Other researchers looking at Massachusetts had found that emergency department visits in Massachusetts had begun falling after expanded health insurance coverage. But a major Harvard study done in Oregon found that people on Medicaid visited the emergency room 40 percent more than a non-Medicaid control group.

The recent research cited many possible reasons for the increase in emergency department visits including “pent-up demand before obtaining health insurance coverage, decreased economic barriers to seeking emergency care, the lack of access to primary care, or a combination of these factors.”


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