Oregon study: Medicaid expansion leads to more ED use

The latest results from a landmark study of a Medicaid expansion program in Oregon found that low-income adults who are enrolled in Medicaid visit hospital emergency departments 40 percent more often than other adults (Source: “Expanding Medicaid increases ER visits in Oregon study,” Los Angeles Times, Jan. 2, 2014).

While federal and state policymakers have argued that expanding Medicaid would reduce costly and inefficient use of hospital emergency rooms by increasing access to primary healthcare, the study, which was published online Thursday in the journal Science, suggests this is not the case.

"When you cover the uninsured, emergency room use goes up by a large magnitude," said senior study author and MIT economics professor Amy Finkelstein. "In no case were we able to find any subpopulations, or type of conditions, for which Medicaid caused a significant decrease in emergency department use."

The study sample, made up mostly of white urban-dwelling patients, showed an increase in ER use after 18 months, and the increase was larger for men than it was for women. 

The study was tied to a 2008 Medicaid expansion program in Oregon, in which officials held a lottery to enroll 30,000 eligible adults out of a total pool of 90,000.