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Emergency Visits Increased 5.7% After Obamacare Was Implemented in Illinois

Key Obamacare goal was to reduce higher-cost services such as emergency room visits

emergency room
AP
September 1, 2016

The number of emergency room visits increased in Illinois after the Affordable Care Act was implemented in 2014, according to a study from the Annals of Emergency Medicine.

The report found that 15.2 million patients visited emergency rooms in 201 Illinois nonfederal hospitals from 2011 to 2015. In 2011, there were 2.9 million visits to the emergency room, and in 2015, the number of visits jumped to 3.2 million, an 8.1 percent increase.

The study, which examined whether the Affordable Care Act affected the number of emergency room visits, looked at data from the state of Illinois because it expanded Medicaid and had large urban, suburban, and rural populations with variations in income and insurance coverage.

"The overall emergency department visit volume increased significantly, corresponding with ACA insurance expansion in January 2014," the report states. "There were steady increases in the proportion of visits by patients aged 55 to 64 years, those from low-income zip codes, and those with other or unknown race and ethnicity."

Average monthly emergency department visits increased by 5.7 percent from the period before Obamacare was implemented, 2011 to 2013, to the period after it was implemented, 2014 to 2015. Medicaid was responsible for most of the increase as emergency visits for those on Medicaid increased by 41.9 percent while visits by those with private insurance increased by only 10.2 percent. Emergency visits for the uninsured declined by 42.4 percent.

According to the Congressional Research Service, emergency room visits are more expensive because they have higher fixed costs including space and staffing, and hospital charges are higher than those in physician’s offices.

One of the goals of Obamacare was to expand insurance coverage to more Americans so they would have access to primary and preventive care, a move that they anticipated would reduce emergency room visits.

"The increase in total emergency department visit volume runs contrary to one of the key intents of health insurance expansion, ‘to reduce higher cost services such as emergency department visits,’" the report states.

Jonathan Gold, a spokesman from the Department of Health and Human Services, says the department is reaching out to those covered by Obamacare who used emergency room services to tell them how best to use their coverage.

"Since the implementation of the Affordable Care Act, Illinois has seen its uninsured rate nearly cut in half, which is consistent with this study’s finding that emergency departments in Illinois have seen a large drop in uninsured patients," Gold said. "As people gain access to affordable, high-quality coverage, they are more likely to get the right care when they need it, but that transition takes time."

"For people who utilized emergency rooms for non-emergency care in the past, we are continuing to work to reach out and provide information on how to best use their new coverage, while also investing in delivery system reform to improve primary care so all Americans can readily access care when they need it," he said.