Harvard Study: Obamacare Drives up ER Visits

Friday, 03 Jan 2014 11:50 AM

By Drew MacKenzie

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The number of costly emergency room visits is set to soar under Obamacare, according to a  "gold standard" Harvard study, which directly contradicts claims by President Barack Obama that his healthcare law would cut ER trips.

The millions of people who have just been enrolled in Medicaid will go to ERs on a regular basis instead of their local doctors, according to the research.

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Obama had said that his signature healthcare reform law would help cut back on government spending by reducing trips to the ER, the Daily Caller reports.

The study, published in the journal Science and released on Thursday, shows that the nearly 4 million new patients subsidized by government under the expansion of Medicaid are more likely to end up seeking treatment in emergency rooms for non-emergency health problems than before they entered the program.

Harvard conducted the study in Oregon in 2008 after that state expanded its Medicaid program. It found that newly-insured Medicaid patients went to the ER 40 percent more than the uninsured.

The findings are the polar opposite of government calculations that these millions of new patients would pick lower-cost options for their healthcare, by going to their primary care physicians.

The study came during Oregon's Medicaid expansion six years ago when the state, with limited funds available, staged a lottery to decide who would get coverage. The researchers compared the trips to ER by those who won the Medicaid lottery and those who were not so lucky and remained uninsured.

The results showed that 25,000 Medicaid patients went to the emergency departments at Portland area hospitals 1.43 times over 18 months while those who were not insured only made 1.02 trips to the ER in the same time frame.

Obama had said the Medicaid expansion would reduce the number of visits to ERs for ailments that could be better treated, and at lower cost to the government, by primary care doctors. But the Harvard research found that Medicaid patients showed up in droves at emergency departments for minor ailments such as colds and flu.

The study found that Medicaid patients who went to the emergency room weren't admitted to hospitals any more frequently than uninsured people.

Calling it "the gold standard" for research on the effects of Medicaid coverage, James Smith, a Rand Corp. economist, said the study showed that Medicaid expansion results in "emergency department use and increases costs." He added, "That doesn't mean it isn't a good thing to do, but that's what it does."

Last year Obama justified his Medicaid expansion under the Affordable Care Act by noting the potential savings from fewer hospital ER visits by the poor, which he says are more expensive than trips to the local GP.

"We just pay for the most expensive version, which is when they go to the emergency room because what happens is the hospitals have to take sick folk," Obama said. "They're not just going to leave them on the streets."

But the Daily Caller points out that Oregon will be forking over even more cash to pay for ER visits, which likely could mean the same problem will happen to every other state in the country that has expanded Medicaid.

Katherine Baicker, an economist at the Harvard School of Public Health, said the study, which she helped to write, concluded that people who gained Medicaid coverage used ERs more often for "a broad range of types of visits, conditions and subgroups," including problems that could be treated in less costly settings.

"That leaves policymakers with the difficult evaluation of comparing the substantial real costs of the program, with the substantial benefits to enrollees of having the coverage," she told Bloomberg.

Although Obama has claimed that his healthcare law would help to lower deficits, the Harvard study will put a big dent in his theory.

"Because we’re driving down costs, we actually end up saving a little money," Obama said last year at a Clinton Global Initiative event. "It is a net reduction of our deficit. The irony of those who are talking about repealing Obamacare because of, it’s so wildly expensive is if they actually repealed the law, it would add to the deficit."

More than 19 million people nationwide are projected to join Medicaid this year, a 35 percent jump from last year as Obamcare widens the number of people eligible for the program. The increase is projected by the Obama administration to boost the program's cost by 18 percent this year and almost double it to $957 billion by 2021.

According to the Daily Caller, 25 states and Washington D.C. will expand Medicaid while nine have rejected the program.

Bloomberg News Contributed to this story.

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