Unintended consequences are the most overlooked factor in setting policy and enacting laws. Sometimes you think you are fixing a problem but fail to address all the elements. This appears the case when it comes to Medicaid expansion. New coverage is obtained; the health care system is not equipped to deal with the expanded coverage and the newly insured revert to their previous source of care creating new problems. We never seem to think this stuff through.
This is why when you hear populist rhetoric offering grand new schemes for expanded social benefits you should be wary. We have yet to see the full long-term implications and cost of Obamacare and yet the left rolls on with new proposals for enhanced Social Security, free college and universal health care.
Emergency-room visits continued to climb in the second year of the Affordable Care Act, contradicting the law’s supporters who had predicted a decline in traffic as more people gained access to doctors and other health-care providers.
A survey of 2,098 emergency-room doctors conducted in March showed about three-quarters said visits had risen since January 2014. That was a significant uptick from a year earlier, when less than half of doctors surveyed reported an increase. The survey by the American College of Emergency Physicians is scheduled to be published Monday.
Medicaid recipients newly insured under the health law are struggling to get appointments or find doctors who will accept their coverage, and consequently wind up in the ER, ACEP said. Volume might also be increasing due to hospital and emergency-department closures—a long-standing trend.
“There was a grand theory the law would reduce ER visits,” said Dr. Howard Mell, a spokesman for ACEP. “Well, guess what, it hasn’t happened. Visits are going up despite the ACA, and in a lot of cases because of it.”
The health law’s impact on emergency departments has been closely watched because it has significant implications for the public. ER crowding has been linked to longer wait times and higher mortality rates.
More than half of providers listed in Medicaid managed-care plans couldn’t schedule appointments for enrollees, according to a December report by the Health and Human Services Office of the Inspector General. Among providers who could offer appointments, the median wait time was two weeks, but more than a quarter of doctors had wait times of more than a month for an appointment.