EDITORIAL: California Medicaid shows Obamacare failure

Aug. 23--email

Advertisement

ONE longtime problem that has caused insurance costs to rise is too many people going to emergency rooms for routine care. Because ER service costs far more than treatment at a doctor's office, this exponentially increases the cost of care.

Among other things, passage of the Affordable Care Act was supposed to dramatically reduce non-emergency use of ERs. Because more people would have coverage, fewer would delay routine care and they would be less likely to use an ER to get cold medicine or similar treatments.

A recent study in California illustrates there was a huge gap between that theory and reality.

California's Democrat-dominated state government eagerly embraced the ACA by expanding the Medicaid program, which is the main method the law used to reduce the uninsured rate. A new report by the California Health Care Almanac, an online clearinghouse for data and analysis, shows Medicaid expansion resulted in no obvious reduction in unnecessary ER visits. In fact, a slight acceleration in the use of ERs occurred.

In 2006, there were 10.1 ER visits per 1,000 people in California. By 2016, that rate had increased to 14.6. Contrary to activists' predictions, the steady increase in ER use observed before Medicaid expansion did not turn into a decline after expansion.

The report notes the number of ER visits by Medicaid patients "almost doubled between 2006 and 2016," rising from 23 percent of patients in 2006 to 43 percent by 2016. That increase is far larger than the reduction in self-pay/uninsured visits, which declined from 16 percent of patients to 7 percent.

Overall, the report found the number of California emergency room visits increased 44 percent between 2006 and 2016. The report found wait times in California emergency rooms were longer than the national median. Patients who were sent home spent nearly three hours in the ER, while those who were admitted were there more than 5 1/2 hours.

In 2016, the report shows, 87 percent of California ER visits did not result in a hospital admission, and 64 percent of those non-admitted patients were there for "minor" to "moderate" conditions. Also, 326,587 people left before being treated in 2016.

Why do people with coverage continue to use emergency rooms for non-emergency care? Because Medicaid rates are notoriously low, often less than the cost of care, and many doctors won't accept Medicaid patients or they limit the number of Medicaid patients they treat. This results in patients having coverage without access to doctors, so they are more likely to use an ER for routine care. Since Medicaid patients pay little to nothing out of pocket, they have no incentive to avoid higher-cost ERs and taxpayers foot an ever-increasing bill.

Similar results occurred in Oregon when it expanded its Medicaid program before passage of Obamacare. The Oregon program was capped at an additional 10,000 people, which allowed researchers to compare expansion patients with non-expansion counterparts. Researchers found those added to Oregon's Medicaid program made 40 percent more visits to the emergency room than their uninsured counterparts during the first 18 months after expansion.

Reducing unnecessary ER visits was a chief goal of Obamacare. On that measure, among others, the law remains a failure.

___

(c)2018 The Oklahoman

Visit The Oklahoman at www.newsok.com

Distributed by Tribune Content Agency, LLC.