ER visits keep climbing under PPACA - Capstone Brokerage

ER visits insurance

By: Kathryn Mayer (Benefits Pro) May 2015

Emergency room visits have increased under the Patient Protection and Affordable Care Act despite the law’s promises and efforts to curb them, ER room doctors say.

Three-quarters of emergency physicians say that emergency visits are going up, according to a new poll by The American College of Emergency Physicians. It’s a significant jump from just one year ago when less than half reported increases.

The jump is driven by more covered Americans under PPACA, especially since the law’s individual mandate took effect, and a continued shortage of primary doctors to care for them.

Specifically, 28 percent report “significant increases” in all emergency patients since the requirement to have health insurance took effect. Only 3 percent of doctors reported any decrease in ER visits. In addition, more than half (56 percent) said the number of Medicaid emergency room patients is increasing.

“America has severe primary care physician shortages, and many physicians will not accept Medicaid patients because Medicaid pays so inadequately,” Dr. Michael Gerardi, president of ACEP, said in a statement. “Just because people have health insurance does not mean they have access to timely medical care.”

Doctors also said they are largely unprepared for more ER patients, with 70 percent saying their ER is not “adequately prepared for potentially substantial increases in patient volume.”

When asked what would happen if federal subsidies for health insurance coverage were to be eliminated in their states in the King v. Burwell case, 42 percent of emergency physicians said they expect emergency visits to increase. Additionally, 65 percent expect reimbursement for emergency care will decrease if those federal subsidies are eliminated.

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