Emergency department visits by uninsured patients drop in Illinois after Medicaid expansion
The ACA expanded Medicaid coverage eligibility to adults with incomes up to 133 percent of the federal poverty level, but the law's fate is uncertain
New research adds to a growing body of evidence suggesting that the expansion of Medicaid under the Affordable Care Act helps low-income families rely less on emergency department visits for medical care, thereby cutting down on unnecessary utilization.
In Illinois between 2009 and 2015, according to the abstract, Medicaid expansion was associated with a significant drop in uncompensated care in emergency departments by patients without insurance. The ACA expanded Medicaid coverage eligibility to adults with incomes up to 133 percent of the federal poverty level.
IMPACT
Researchers analyzed emergency department visits using data from the Healthcare Cost and Utilization Project and found there were a total of 31.2 million emergency department visit in Illinois during the study period. Of these, 4.1 million were visits by uninsured patients.
Uninsured emergency department visits in the state peaked right before ACA implementation, when they accounted for 16 percent the visits. Post-ACA implementation, there was a 40 percent reduction in uninsured emergency department visits.
Author Dr. Peter Nguyen, a pediatric emergency medicine fellow at Michigan State University's Helen Devos Children's Hospital, said that proposed policy changes may slow the reduction in uncompensated emergency department visits.
With increasing uncertainty about the long-term plan for the ACA, enrollment has started to decline, which could perhaps be a harbinger for another rise in uninsured emergency department visits.
THEIR TAKE
"As a result of the ACA, 850,000 people in Illinois gained health insurance during the study period," said Nguyen. "During the same time, we saw a significant drop in emergency department visits by patients without insurance.
"This study adds to the growing body of evidence that the ACA can be beneficial in promoting patient-centered care, shifting it from the emergency department to a patient's medical home for ongoing, comprehensive care. This is a healthier situation for everyone."
THE TREND
Republicans could try again to repeal the ACA if they win enough seats in the midterm election this November, Senate Republican Leader Mitch McConnell said last month, according to Reuters.
Republicans last year tried and failed to repeal the law. In another attempt to get rid of the individual and employer mandates for coverage, the GOP this summer introduced the "skinny" repeal in the Health Care Freedom Act. The individual mandate was nixed in the Bipartisan Budget Act.
Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com
