EMERGENCY ROOMS AND THE AFFORDABLE CARE ACT
The Affordable Care Act (ACA) came into law in 2010, and it was meant to ensure that all Americans had access to health insurance so that they could access affordable health care. One of the main hopes when establishing the ACA was that many patients wouldn’t visit the ERs and would instead visit regular doctors where treatment is cheap. However, years after the ACA came into effect, people are still visiting the ERs, with some states recording a slight increase in ER visits.
Bellaire ER is one of the ERs that have been affected by the visits from uninsured patients, and we know just how costly it can be. Most of the uninsured patients wait until their condition gets worse so that they can visit the ER. This results in higher treatment costs. Since ERs are mandated to offer medical care to their patients, regardless of their ability to pay, they are the preferred source of medical care for the poor and uninsured people.
Due to many visits from people who couldn’t clear their medical bills, ERs are left with millions of bad debt which puts a strain on their resources.
The Affordable Care Act aimed to expand health insurance coverage in the country and would hence reduce the number of uninsured people that had to wait for their condition to worsen to visit the ER. The ACA also provided for the expansion of Medicaid to include more low-income earners that were not eligible for the plan before.
The Supreme Court made a ruling that states had the option to accept or reject Medicaid expansions. Texas is one of the states that chose to reject them.
Overall, the ACA has managed to get more people to enroll for health insurance through various incentives. However, the number of people visiting the ERs in the expansion and non-expansion states has mainly remained the same. The difference is that this time, the number of uninsured patients in the ER has decreased. The decrease has been significantly larger in the expansion states than the non-expansion states as noted in a study published in the Health Affairs journal.
Although the expansion states have had an increase in insured visits, the number of people with private medical insurance has gone down by around 7 percent compared to the non-expansion state.
As more data becomes available, ERs will be looking at the balance between the Medicaid patients and the privately insured patients due to the disparity in payments. Generally, Medicaid pays more than uninsured patients but less than private insurance. These variations will show whether it is better to expand or opt to stay as a non-expansion state.
Analysts predict that lack of change in the number of ER visits, especially in the expansion states has little to do with the ACA and instead it is mostly about how the healthcare system works.
Most of the people that visit the ER are in serious conditions and need urgent medical care. In such a scenario, ERs are still the best equipped medical care facilities to attend to such cases.
Most people in these serious conditions also prefer to visit the ER due to the timely access to medical care. Since in the ER you are treated based on the urgency of your situation, patients who need urgent care usually visit the ER.
It is also notable that most of the primary care doctors do not accept Medicaid. Therefore, the insured patients have no option but to visit the ER.
A CDC report showed that 77 percent of the people visiting emergency rooms go because they have serious conditions. Another 12 percent opt for the ER because their doctor’s office is closed. These are visits that usually occur on weekends and holidays. Other people opted for the ER because it was their only option.
These figures show that the ACA remains challenged on reducing visits to the ER. This is because most of the people visiting the ER are there because of issues other than affordability. The point at which the ACA was meant to make headway is in reducing the number of people that delay health care. However, due to the unwavering numbers, these effects remain to be seen.
Some analysts also blame the sustained use of ERs on the habit. Most of the newly insured patients under the expanded Medicaid program were used to going to the ER. Most of them have continued with this habit as visiting the ER is familiar, and it’s a routine they are used to.
America also has a great population of the older generation who are more likely to have chronic illnesses that require a visit to the ER. Therefore, these people will still visit the ER whether they have insurance or not.
The Affordable Care Act has done little to reduce the stress on emergency rooms. However, it has helped people get access to healthcare and given the emergency rooms some financial security.