Despite the goals of Obamacare to reduce the number of visits by patients to the emergency room, three-quarters of emergency room physicians say they have seen ER patients visits rise since Obamacare took effect.
In a poll released by the American College of Emergency Physicians, researchers found that 28 percent of 2,099 doctors surveyed nationally saw a large increase in patient volume, while 47 percent saw slight increases. In contrast, fewer than half of the doctors surveyed reported any increases last year in the early days of the Affordable Care Act.
In Ohio, for example, emergency room visits actually dropped by more than 68,000 during the first three months of 2014 compared with the same time in 2013. However, ER visits were higher in the second quarter of 2014 compared with the same months in 2013, according to John Palmer, spokesman for the Ohio Hospital Association. Data for the second half of 2014 were not yet available.
These increases run counter to one of the goals of the health care plan, which is to reduce the pressure on emergency rooms by getting more people insured through Medicaid or subsidized private coverage and providing better access to primary care.
One of the main reasons this has occurred is due to a lack of primary care physicians to handle all the newly insured patients, said ACEP President Mike Gerardi, an emergency room physician in New Jersey.
"They don't have anywhere to go but the emergency room," he said. "This is what we predicted. We know people come because they have to."
The federal government predicts the shortage in primary physicians to reach or even exceed 20,000 doctors by 2020, and some physicians won't accept Medicaid because of its low reimbursement rates.
Emergency room use is bound to increase if there aren't enough doctors who accept Medicaid patients and "no financial penalty or economic incentive" to move people away from ERs, said Avik Roy, a health care policy expert with the free market Manhattan Institute.
"It goes to the false promise of the ACA," Roy said, that Medicaid recipients are "given a card that says they have health insurance, but they can't have access to physicians."
"Nobody wants to turn anyone away," said Maggie Gill, CEO of Memorial University Medical Center in Savannah, Georgia. "But there's no business in this country that provides resource-intensive anything and can't even ask if you're going to be able to pay."
Seven in ten doctors say their emergency rooms aren't ready for the continuing, and potentially significant, increase in patient volume. While numbers should level off as people finally receive care, patent demand will continue to outpace the supply of physicians for quite some time.
