NEJM Study: New Medicaid Enrollees Continued To Use the ED Too Much

The expansion of Medicaid under the ACA has been celebrated in a lot of quarters because it brings care to a population that needs it badly and which too often used the emergency department (ED) as its primary care provider. Studies have shown that gaining coverage did indeed encourage beneficiaries to see the doctor more often and reduced rates of depression. Not to mention they could now afford getting care.

However, a study in the New England Journal of Medicine that focused on a program that expanded Medicaid in Oregon showed that use of the ED by new Medicaid beneficiaries stayed high even two years after they signed on. With about 25,000 participants, it’s one of the largest randomized studies to look at the impact of gaining coverage.   

Researchers concluded: “For policymakers deliberating about Medicaid expansions, our results, which draw on the strength of a randomized, controlled design, suggest that newly insured people will most likely use more health care across settings — including the ED and the hospital—for at least two years and that expanded coverage is unlikely to drive substantial substitution of office visits for ED use.”

Source: New England Journal of Medicine