Study: Medicaid patients use emergency room more, not less
posted at 7:01 pm on January 2, 2014 by Mary Katharine Ham
A new study of Medicaid beneficiaries in Oregon makes a strong version of this case. The study, published today in the journal Science, finds that adult Medicaid beneficiaries rely on emergency rooms about 40 percent more than similar uninsured adults.
“When you cover the uninsured, emergency room use goes up by a large magnitude,” said Amy Finkelstein, a health economist at the Massachusetts Institute of Technology who served as a lead investigator on the study, in an MIT press statement accompanying the study.
There were no exceptions to the trend. “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,” said Finkelstein.
We’ve seen real-world evidence that Medicaid increases emergency room utilization before, in states like California. But the Oregon study should settle any lingering debate.
These results, reported by Peter Suderman at Reason, were reported in the journal Science and are based on the Medicaid study in Oregon that made news in May for showing Medicaid patients had no material health improvements over the uninsured.
The Oregon study is important because it’s a randomized controlled trial— the research gold standard we’ve reported on before in studies like the Tennessee Pre-K study and the Washington, D.C. Opportunity Scholarship study. Washington state held a lottery for access to Medicaid and then studied the both the cohort that got Medicaid and the cohort that did not. This means the cohorts were randomly selected within a group of people with similar motivations, economic situations, etc., making them more accurately comparable.
Suderman notes that Medicaid recipients are less likely to experience ” feel better after they are covered, and they are much less likely to be subject to large, health-related financial shocks,” making it largely a “financial buffer” instead of a health program. If our friends on the Left were as pro-science as they purport to be, they’d acknowledge it’s worth discussing whether we’re accomplishing what we want to accomplish with these very expensive programs. Research shows we’re not helping people as advertised. If we’d like to actually help people instead of just patting ourselves on the back for saying we’re helping them, we’ve got to rethink these programs instead of expanding them. If anything, the Oregon study offers a pretty decent argument for Republican governors that skipping Medicaid expansion wasn’t just the right fiscal decision, but the right one for general health outcomes and emergency room crowding.