Emergency Visits Have Not Gone Down Since the ACA


Emergency visits are increasing despite the Affordable Care Act (ACA), according to a report by the Centers for Disease Control and Prevention. Jay Kaplan, MD, FACEP, president of the American College of Emergency Physicians (ACEP) said, “The reliance on emergency care remains stronger than ever. Just because you have health insurance does not mean you have access to timely medical care. Every shift, I treat patients who couldn’t access a primary care physician and had no choice but to come to the emergency department because their condition worsened dramatically. America has severe primary care physician shortages; many doctors will not accept Medicaid patients because Medicaid pays so inadequately.”

According to a 2015 ACEP poll, three-quarters of emergency doctors said that emergency visits had gone up since the implementation of the ACA. Most said that the availability of urgent care centers, retail clinics, and telephone triage lines have done little to reduce emergency visits.

There is strong evidence that Medicaid patients don’t have timely access to primary care and specialty care. The median wait time for Medicaid providers is two weeks, but over one-quarter have wait times of more than a month. More than half of providers listed by Medicaid managed care plans are not offering appointments to enrollees. This is despite an ACA provision that boosts pay to primary care doctors who treat Medicaid patients.


HSA Rollovers Are Increasing

While there have been some ups and downs, rollovers in health savings accounts (HSAs) are generally increasing, according to data from EBRI/Greenwald & Associates. When an employer offers an HSA health plan, any money left in an account at the end of the year rolls over automatically, and is available in the following year since there is no use-it-or-lose-it rule. However, employers can restrict the amount carried over. The survey also finds the following:

  • The number of accounts with a rollover increased annually until 2013. The total level of assets being rolled over has increased in all years except for 2010, 2013, and 2014. In 2008, 2.5 million accounts rolled over $2.5 billion.
  • Conversely, the share of accounts without a rollover has been going down. In 2008, 16% of people with an HSA or health reimbursement account did not roll over any money. By 2014, that had decreased to 11%.
  • By 2014, 7.1 million accounts rolled over $8.9 billion. The average rollover increased from $1,000 in 2008 to $1,244 in 2014.
  • Accounts with an employer contribution had a higher amount rolled over than did those without an employer contribution in 2014.

Dental Care Is Still Out of Reach for Many

In year two of the Affordable Care Act (ACA), one quarter of respondents to a survey by DentalPlans went without dental care in the prior 12 months because they couldn’t afford it. The average American dental expenditure is $6661 a year. Only 7% of adults have dental insurance through a plan purchased on Healthcare.gov. More stand alone dental plans offer family dental benefits, giving adults more dental insurance plan options this year. Bill Chase, vice president of marketing for DentalPlans said, “While the availability of and information on dental benefits was more evident in the 2015 Federally Facilitated Marketplaces, the ACA still fails to meet the oral care needs of most adults and seniors. Once again, oral care for adults is an optional benefit, requiring adults to purchase additional stand alone dental plans if they want coverage, costing additional money, while not being eligible for assistance.”

Proposed Obamacare Rates 12% higher for 2016

Affordable Care Act (ACA) premiums will go up an average of 12% for 2016 over 2015, according to a report by HealthPocket. The company analyzed rate filings for 3,771 plans in 45 states. Silver plans, the most popular exchange plan, account for 67% of exchange plan selections. The proposed 2016 rates for  averaged 14% higher for Silver plans, 16% higher for Gold plans , 9% higher for entry-level Bronze plans, and 6% higher for Platinum plans.

Proposed rate increases vary depending on the type of plan. For example, rate proposals for HMO and EPO Bronze plans were 20% higher than 2015 while PPOs were only 4% higher. The 2016 rates represent the first time Affordable Care Act insurers have had a full year of medical claims data with enrolles who cannot be turned away due to a  pre-existing condition. Proposed rates must be reviewed and approved by state insurance regulators, which may result in lowering some proposed rates. Some consumers will see lower premium increases due to subsidies, but unsubsidized consumers will endure the full cost of any approved rate increase.

CDC: Rate of severe birth complications in U.S. is increasing

The number of women who experienced severe complications during or after childbirth nearly doubled between 1998 and 2009, CDC researchers found. However, childbirth-related complications and deaths remained uncommon in the U.S., with an estimated 590,000 cases reported in over 11 years. The findings appear in the journal Obstetrics & Gynecology. Reuters (10/23

Last Updated 05/25/2022

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