Medicaid expansion leads to drop in doc, ED visits among the uninsured

States that expanded Medicaid eligibility under the Affordable Care Act also saw a decline in the number of uninsured adults who visited physician offices and emergency departments, according to a new study.

In states that expanded Medicaid eligibility, the number of uninsured adults making office and outpatient visits to doctors declined substantially from 8.4 percent in 2011 through 2013 to 5.6 percent in 2014, when the ACA took effect, according to a Heatlh Affairs Blog post. Correspondingly, there was an uptick in visits from Medicaid patients from 13.4 percent in 2011 through 2013 to 16.7 percent in 2014, researchers found.

The same trend proved true for ED visits. In states that expanded Medicaid, the uninsured share of ED visits declined by approximately one-half from the 2011 to 2013 figure to 2014, dropping from 19.8 percent to 10.5 percent, according to the findings published in an Agency for HealthCare Research and Quality (AHRQ) statistical brief.

The same could not be said for states that failed to expand Medicare eligibility. No significant reductions in uninsured visits to physicians or the ED were observed in those states.

The number of patients with Medicaid coverage increased from 22.2 percent in 2011 through 2013 to 34.8 percent in 2014 in those state that expanded Medicaid programs.

The study used data from the Household Component of the Medical Expenditure Panel Survey to look at ambulatory care visits before and after the ACA. Researchers said the shifts they noted may be due to a number of factors, “not only the reduction in the uninsured share of the population, but also the health risks of those who self-selected into coverage, their healthcare seeking behaviors, and availability of provider capacity.”

While Medicaid expansion has reduced the number of insured patients, it has also been more expensive than anticipated, according to a recent report. States that expanded Medicaid eligibility have also seen a decrease in levels of uncompensated care at their hospitals.