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Colorado Medicaid Expansion Could Result in More ER Visits

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Colorado has expanded the Medicaid program, as part of the state’s implementation of the Affordable Care Act.  That means tens of thousands of new Medicaid patients will have access to healthcare.  Proponents of the Affordable Care Act say that getting more people insured will cut down on emergency room visits, but a recent study shows that is not what happened in Oregon according to a recent conversation on Colorado Matters from Colorado Public Radio.

Katherine Baicker is a researcher at the Harvard School of Public Health, and a lead author about the Oregon study.  She says her findings surprised some.

"Patients who were hesitant to go to the emergency department when they were uninsured wouldn't face that cost barrier once they gained access to Medicaid and that would suggest an increase to emergency department use, which is just what we saw," Baicker said.

The study also saw an increase in the use of primary care, physician visits, and prescription drug use.  

Judy Zerzan is the chief medical officer at Colorado’s Department of Health Care Policy and Financing.  She says the study findings didn’t surprise her.

"There's a lot of pent-up demand; this population has a lot of mental and physical health issues," Zerzan says, "There's other studies, like on Medicare.  People are much more expensive their first year or maybe two on Medicare, often because they haven't had health insurance before. And so they've put off a lot of those things. And then after that first year or two, their health expenditures go down, and we expect the same."

Zerzan says she expects in ER visits to be small due to the state’s preparation implementing the Accountable Care Collaboratives.

"That's a program whose main design is to improve people's costs and reduce the cost of Medicaid," Zerzan says.

More details about the impact of Medicaid coverage from Colorado Matters can be found here.  You can also hear a podcast of the entire conversation.