Study: ER visits surge, even after Medicaid expansion

Enrolling more people in Medicaid may actually lead to more emergency room visits, not fewer, according to a study published Thursday in the New England Journal of Medicine.


Researchers found that ER visits among people who signed up for Oregon’s Medicaid program remained high for the first two years of coverage. It presents an alarming trend as health officials nationally try to push people into physicians’ offices instead of the more costly emergency care. 

The study is based on the Medicaid program in Oregon, which entered people into a lottery for coverage in 2008.

About one year into that program, researchers were surprised by a 40 percent spike in emergency room visits. Some health experts blamed the surge on “pent-up demand” among people who had lacked insurance.

But the follow-up study, which led by economists at the Massachusetts Institute of Technology and the Harvard T.H. Chan School of Public Health, showed that the emergency room visits remained high over two years.  

The results throw cold water on an idea that was popular during the drafting of ObamaCare: that giving people coverage would drive down ER visits.

Instead, the researchers found, people with health insurance are more likely to use a range of services — including the ER.

“One possible reason for this finding is that the type of people who use more care when they gain Medicaid coverage are likely to increase use across multiple settings,” the researchers wrote.