Health Insurance Coverage Increased ER Use in Massachusetts

Health reform in Massachusetts led to a small, but consistent increase in emergency department use, according a study to be published online in Annals of Emergency Medicine. “This obviously has implications about what we can expect to see nationally as the roll-out of the Affordable Care Act continues. We cannot say, for sure, why more people came to the ER – whether it’s a lack of access to primary care or the result of pent-up demand, but we need to be ready. Other states should be prepared for equal or greater influxes of patients into the ER after reform is fully implemented,” said Peter Smulowitz MD, FACEP, of Beth Israel Deaconess Medical Center in Boston, Mass.

“Our study should further weaken the long-held notion that high use of the emergency department is driven mainly by the uninsured, said Dr. Smulowitz. Barriers to primary care are serious and persistent across the country. It appears that when people have health insurance, they will seek medical care wherever they can get it, which is sometimes only the ER,” he added. Emergency department visits increased by as much as 1.2% from October 1, 2006 to September 30, 2007 after Massachusetts implemented its first-in-the-nation law to increase health care insurance coverage. That rose to a 2.2% increase in ER visits for the period ending September 30, 2009. Emergency visits by under 65 uninsured people decreased from 9.5% of visits before health reform to 5.7%  after health reform. Emergency department visits from those 65 and older remained steady at about 1%. For more information, visithttp://www.acep.org.

Last Updated 11/25/2020

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