The Leaflet: Affordable Care Act Increases ER Visits

Published May 29, 2015

Affordable Care Act Increases ER Visits

Emergency rooms (ER) in hospitals around the nation are facing overcrowding, leading to longer wait times and higher mortality rates. Considering one of the stated goals of the Affordable Care Act (ACA) was to reduce the amount of patients using ER visits for primary care, legislators will have to weigh the costs and benefits associated with increased patient demand.

According to an American College of Emergency Physicians (ACEP) study, there have beennoticeable increases in the number of people seeking ER care. Over 75 percent of the 2,099 doctors surveyed said they witnessed increases in the number of patients using ER services. Forty-seven percent of those responding to the ACEP poll saw a slight increase in ER visits and 28 percent reported a large increase. Fifty-six percent found an increase in the number of Medicaid patients using emergency rooms. Eighty-six percent of the doctors surveyed reported the severity of the illness or injury among emergency room patients either increased or remained the same since ACA’s implementation.

The Colorado Hospital Association found in a recent study emergency room visits in states that expanded Medicaid under Obamacare increased by 5.6 percent in 2013–14, far outpacing the 1.8 percent increase reported by states that did not expand Medicaid. A 2008 Harvard University study found newly insured Medicaid patients went to the emergency room 40 percent more often than uninsured patients after Oregon expanded its Medicaid program.

Heartland Institute Senior Policy Analyst Matthew Glans said, “One of the many goals of ACA was to lessen the burden of uninsured patients on the nation’s emergency rooms. The new laws attack the wrong problem and accomplish the opposite by pushing states to expand their failed Medicaid systems to cover more people. Repealing ACA and Medicaid expansion would decrease the pressure on the nation’s emergency rooms.”

Budget and Tax
States’ Growing Autonomy Frees Up Federal Highway Funding
Kenneth Orski writes in Heartlander about the recent shift in transportation funding away from the federal government and the increasing share of transportation funding coming from state and local levels. Several experts discuss how this change could affect future infrastructure projects. “Using local funds enables states to avoid cumbersome federal requirements that increase project costs and delay implementation. States have a genuine incentive to embrace a more proactive role in funding transportation.” Read more

Energy and Environment
Papal Climate Conference, Statement Ignore Evidence
Pope Francis recently held a one-day conference, “Protect the Earth, Dignify Humanity: The Moral Dimensions of Climate Change and Sustainable Development,” as a preface for his upcoming encyclical on climate change. In this Climate Change Weekly article, Research Fellow H. Sterling Burnett points out the pope had no skeptics of climate change present at the conference.

Some researchers, such as Lord Christopher Monckton, suggest the pope has no place in commenting on science. Other researchers voicing their dismay over the pope’s expected climate proposals include Jay Lehr, Heartland Institute science director, who says the pope’s concern about extreme weather events is misplaced, and Hal Doiron, a retired NASA scientist who observes, “The global average surface temperature has not increased at all, in sharp disagreement with the continued rapid warming predicted by the U.N.’s climate models.” Read more

Energy and Environment
Best Options for Potential Nuclear Power Plant Closings in Illinois
Exelon claims three of its Illinois nuclear power plants are uneconomical and has asked the Illinois legislature to allow it to force ratepayers to pay more to keep them operating. The authors of a new Heartland Policy Brief say that would be a mistake. Heartland Institute Senior Fellow James M. Taylor and former Heartland Policy Analyst Taylor Smith analyze the issues and conclude the best option for Illinois taxpayers and electricity consumers is to allow uneconomical power plants to close so free competition and market forces can provide the most economical power options. Read more

“Blended Learning” Could Be an Answer for America’s Education Woes
Bruno Behrend, a senior fellow for education policy at The Heartland Institute, expressed many concerns about the current state of education in the United States. Behrend says school choice is in grave danger and stated, “It’s difficult to beat a failing system if the support level for the status quo system is above 50 percent.” Behrend voiced his overwhelming support of “blended learning,” in which a part of a student’s education is provided through digital and online media, including organizations like Khan Academy. Behrend also argues many of the benefits of school choice are more freedom and diversity, more parental support, less government indoctrination, and a less expensive and bureaucratic system. Read more

Health Care
Research & Commentary: Alaska Medicaid Expansion Update
Alaska Gov. Bill Walker (I) made Medicaid expansion a central issue even though the state legislature has opposed expanding Medicaid under the Patient Protection and Affordable Care Act (ACA). Many policy analysts contend expansion would be expensive and would not provide better or more affordable health care for Alaskans.

In this Research & Commentary, Heartland Institute Senior Policy Analyst Matthew Glans contends, contrary to expansion supporters’ depiction of new federal funds as “free money,” Medicaid expansion is expensive and creates new costs the federal government may not always cover, leaving state taxpayers on the hook for new liabilities. He writes, “Without significant reform, Medicaid will remain fiscally unsustainable. Alaska should avoid expanding a flawed model that is costly, delivers subpar health care, and shifts more power to the federal government.” Read more

Maryland County Council Dials up Telecom Tax Hike
In this Heartlander article, Amelia Hamilton discusses a proposal being considered by the Prince George’s County Council that would increase the Maryland county’s tax on landline and wireless phone service by 4 percentage points. The hike would increase the telecom tax from 8 percent of a user’s bill to 12 percent of the bill, representing a 50 percent increase. Critics of the hike, including Steven Titch, a telecommunications policy advisor for The Heartland Institute, argue the hike would increase the burden on the county’s taxpayers. Read more

From Our Free-Market Friends
Center of the American Experiment 25th Anniversary Celebration
American Experiment will host the 2015 Annual Dinner on Tuesday, June 2nd at the Hilton Minneapolis. This dinner will celebrate the Center’s 25th birthday and will feature keynote speaker P. J. O’Rourke. O’Rourke is one of America’s premier political satirists, having both TIME and The Wall Street Journal labeling him the “funniest writer in America.”  Come hear this hard-bitten, cigar-smoking conservative as he bashes all political persuasions. Register for the dinner here.




The April issue of Budget & Tax News reports the Federal Communication Commission has adopted so-called “net neutrality” regulations, voting to regulate Internet service providers as utility companies under the authority of Title II of the Communications Act of 1934. FCC Commissioner Ajit Pai, who voted against the regulation, says the plan is a solution in search of a problem.