Medi-Cal Patients Flocking to ERs More Than before Obamacare

By Browning, Kellen | Daily News (Los Angeles, CA), June 12, 2017 | Go to article overview

Medi-Cal Patients Flocking to ERs More Than before Obamacare


Browning, Kellen, Daily News (Los Angeles, CA)


Medi-Cal patients are swamping California emergency rooms in greater numbers than they did before the Affordable Care Act took effect, despite predictions that the health law would ease the burden on ERs.

Emergency room visits by people on Medi-Cal rose 75 percent over five years, from 800,000 in the first quarter of 2012 to 1.4 million in the last quarter of 2016, according to data recently released by the state's Office of Statewide Health Planning and Development.

The most dramatic increase began roughly around the time the ACA expanded health care benefits in January 2014. More than 5 million Californians have gained coverage under the ACA, either through the expansion of Medi-Cal, California's version of the Medicaid program for low-income people, or by purchasing health plans from Covered California, the state's Obamacare insurance exchange.

The architects and proponents of Obamacare had argued that once people got health coverage they would stop going to the ER so much, because they could visit primary care doctors instead. But in reality, people who were uninsured before the ACA were actually reluctant to go to the ER unless they were "about to die," because they would be saddled with big bills, said state Sen. Richard Pan (D-Sacramento), a pediatrician. Under Medi-Cal, though, patients aren't worried about those expenses.

And old habits die hard: A newly-insured patient accustomed to visiting the ER for treatment might not immediately switch to a primary care doctor who is, "just a name -- not somebody you know," Pan added.

Still, experts believe fewer Medi-Cal patients would be visiting the ER if there were more doctors willing to treat them.

Though "we have seen a very strong increase in the number of Medi-Cal patients ... the number of doctors willing to see Medi-Cal patients has not increased accordingly," said Jan Emerson-Shea, vice president of external affairs for the California Hospital Association.

Dr. Marc Futernick, the immediate past president of the California American College of Emergency Physicians, agreed that "there aren't adequate providers for the demands." He said he believes Medi-Cal's low payment rates for physicians play a role. …

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