Medicaid expansion increases ER visits

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  • 08/21/2022

This article originally appeared on

One of the many promised benefits of expanded Medicaid coverage, according to advocates of the Affordable Care Act, was a reduction in emergency room visits. Seeking treatment in the emergency room is typically far more costly than visiting a primary care doctor for treatment.

Recent research, however, shows the opposite: Emergency room (ER) use has climbed, instead of fallen, as a result of Medicaid expansion.

According to a report by the Colorado Hospital Association, “The average number of emergency department (ED) visits to hospitals in expansion states increased 5.6 percent from second-quarter 2013 to second-quarter 2014… In comparison, hospitals in non-expansion states reported a 1.8 percent increase in Emergency Department visits between the second quarters of 2013 and 2014.”

Other reports have found similar increases in ER use by Medicaid patients in Massachusetts, Oregon, and California, in addition to numerous media reports documenting increased use since the Medicaid expansion went into effect.

“[M]edical problems that cause them to go to the ER could often be dealt with in a doctor’s office,” wrote John R. Graham of the National Center for Policy Analysis in an August 15 blog post. “Medicaid patients use expensive Emergency Departments because Medicaid’s low physicians’ fees discourage doctors from seeing them.”

Sean Parnell ( is managing editor of Health Care News


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