A Harvard University study published Thursday concludes that Medicaid enrollment significantly boosts emergency room visits.
This is in direct contradiction to the Obama administration’s claims that his healthcare reform law would put a dent in costly visits to the ER as a way to cut spending.
Harvard researchers had a unique opportunity in Oregon’s 2008 Medicaid expansion. The state had limited funding to expand the program and established a lottery to decide who would get coverage. The study followed the healthcare consumption of those that won Medicaid coverage and those in the lottery that didn’t.
As it turns out, there was a 40 percent increase in ER visits by those who made it into Medicaid. Medicaid patients went to the emergency department 1.43 times in 18 months on average, while lottery hopefuls that didn’t make it into the program only made an average of 1.02 visits.
And what’s more, the increased visits are for the same primary care services that President Barack Obama singled out as a factor Obamacare’s Medicaid expansion would cut down on. Researchers found no decline in ER visits for smaller ailments such as colds and flus, which would be better treated by primary care physicians instead.
The study pushes back against much of the Obama administration’s justifications for the Medicaid expansion.
In November, President Obama spoke about the healthcare law in New Orleans, chastising Republican Gov. Bobby Jindal for declining Obamacare’s Medicaid expansion.
When it comes to poor residents’ coverage, Obama claimed that “we just pay for the most expensive version, which is when they go to the emergency room because what happens is the hospitals have to take sick folk.” But in Oregon’s experience, taxpayers are actually on the hook for even more emergency room services.
“I would view it as part of a broader set of evidence that covering people with health insurance doesn’t save money,” Jonathan Gruber, a health economist at the Massachusetts Institute of Technology, told the Washington Post. “That was sometimes a misleading motivator for the Affordable Care Act. The law isn’t designed to save money. It’s designed to improve health, and that’s going to cost money.”
But if Obamacare wasn’t designed to be a money-saver, the Obama administration certainly tried to sell it as one. Obama himself has repeatedly talked up controversial Congressional Budget Office estimates that claimed the health care law would lower deficits.
“Because we’re driving down costs, we actually end up saving a little money,” Obama said at a Clinton Global Initiative event in September. “It is a net reduction of our deficit. The irony of those who are talking about repealing Obamacare because of, it’s so wildly expensive is if they actually repealed the law, it would add to the deficit.”
While these figures have been heavily disputed, the Harvard study amounts to a big hit against those arguing against the Medicaid expansion included in Obamacare.
The federal government will foot the bill for states that go forward with Obamacare’s Medicaid expansion until 2023, when states’ share of the costs will increase.
So far, 25 states and Washington, D.C. have opted to expand Medicaid and at least 9 have said no to the program.
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