Today's faux outrage by Republicans and others that want nothing less than the repeal of the Affordable Care Act (ACA aka ObamaCare) centers on a new study by Amy Finkelstein of Harvard.
Finkelstein's study shows a marked increase in emergency room visits by those newly receiving health insurance via Medicaid expansion in Oregon. From this report on the study, which is published in the journal Science:
“When you cover the uninsured, emergency room use goes up by a large magnitude,” says Amy Finkelstein, the Ford Professor of Economics at MIT and a principal investigator of the study, along with Katherine Baicker, a professor at the Harvard School of Public Health.
The study, which is being published today in the journal Science, also documents that having Medicaid consistently increases visits to the emergency room across a range of demographic groups, types of visits, and medical conditions, including types of conditions that may be most readily treatable in primary-care situations.
“In no case were we able to find any subpopulations, or type of conditions, for which Medicaid caused a significant decrease in emergency department use,” Finkelstein adds. “Although one always needs to be careful generalizing to other settings, these results suggest that other Medicaid expansions are unlikely to decrease emergency room use.”
But let's think about this for second. Let's assume that for many, if not most, of those in the Medicaid expansion program, this may be the first time in their lives that they have had health insurance coverage. It is very unlikely that these people have ever had a primary care provider, and that the only experience with the health care system they have had is via an emergency room.
Shouldn't it be expected then that instead of doing what those that have always had health insurance do - find a primary care provider - that they would do what they know, what they have always done?
Over time, through outreach and education by state HHS agencies, shouldn't emergency room use drop as these people find a primary care provider?