Why a Medicaid Card Doesn’t Guarantee Coverage
The New York Times has a story this morning about a new report issued by the Centers for Disease Control giving detailed statistics on nationwide emergency room usage in 2007, the most recent year for which data are available. The study found that Medicaid patients comprised more than a quarter (25.2%) of all ER visits nationwide; because the Census Bureau estimates that in 2007, 14.1% of all households had Medicaid coverage, these data mean that Medicaid patients are disproportionately likely to visit the emergency room for care. The study also found that Medicaid patients were more likely to present at the ER with semi-urgent or non-urgent symptoms than those with Medicare or private insurance – and nearly as likely to present with semi-urgent or non-urgent symptoms as the uninsured.
This week’s report follows on the heels of a May CDC survey providing preliminary findings. While conventional wisdom suggests that emergency rooms spend most of their time treating uninsured patients, the studies once again confirm that the uninsured DON’T visit the ER the most often – patients with Medicaid do. Specifically, more than 30% of Medicaid patients under 65 visited the ER at least once in 2007, compared to fewer than 20% of both uninsured patients and patients with private insurance. And Medicaid patients were more than twice as likely as the uninsured to visit the ER at least twice in that year – more than one in seven (15%) Medicaid patients under 65 made multiple ER trips, compared to only 7% of the uninsured and 5% with private insurance. As an ER physician quoted in a May article noted, “High Medicaid utilization [of the ER] is no surprise; many patients have difficulty finding primary care providers who take Medicaid, so the ER is the only alternative.”
With 18 million more Americans set to obtain their health “coverage” (if they can find it) under Medicaid as a result of the health care overhaul, how will emergency rooms cope if many – or even some – of these patients utilize the ER as their primary source of treatment? And how does adding more people into a broken Medicaid system constitute “reform?”