ER Visits Up Since Implementation of Affordable Care Act

Nearly half of emergency physicians responding to a poll are already seeing a rise in emergency visits since January 1 when expanded coverage under the Affordable Care Act (ACA) began to take effect. In an online poll conducted by the American College of Emergency Physicians (ACEP), 86% expect emergency visits to increase over the next three years. Seventy-seven percent say their ERs are not adequately prepared for significant increases.

Alex Rosenau, DO, FACEP, president of ACEP said, “Emergency visits will increase, in large part, because more people will have health insurance and therefore will be seeking medical care. But America has severe primary care physician shortages, and many physicians do not accept Medicaid patients because Medicaid pays so low. When people can’t get appointments with physicians, they will seek care in emergency departments. In addition, the population is aging, and older people are more likely to have chronic medical conditions that require emergency care.”

The data suggest that states that have expanded Medicaid are more likely to see increases in the volume of Medicaid emergency patients. He added, “Long-term solutions, such as increasing the supply of primary care physicians, will take years to develop and will not solve our immediate and short-term problems. Congress and President Obama must make it a national priority now to strengthen the emergency care system. ACEP is urging Congress to make a firm commitment to emergency patients by holding a hearing to examine whether additional strains are occurring in the emergency department safety net as a consequence of the Affordable Care Act.” An overwhelming 84% of emergency physicians report that psychiatric patients are being held in their emergency department, with 91% saying that this practice has led to violent behavior by distressed psychiatric patients, distracted staff, or bed shortages, all of which may harm patients.

“People having a mental health crisis seek care in emergency departments because other parts of the health care system have failed them. Because of the critical shortage of mental health resources, some of these vulnerable patients wait for days in emergency departments. It is simply inhumane,” said Dr. Rosenau. More than half of the physicians said that the time and effort their emergency department takes to transfer psychiatric patients who need admission has increased since January. For more information, visit

Last Updated 08/10/2022

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