Well, Who Didn’t See That Coming?

One of the great advantages of Obamacare is that it makes health insurance available to those who could not previously qualify. One of the great disadvantages of Obamacare is that it makes health insurance available to those who could not previously qualify.

So what’s the problem? Here’s one.

A major goal of the Affordable Care Act (ACA) was to increase the number of insureds and simultaneously decrease the number of hospital emergency room visits. ER visits are much more expensive than visits to a private physician (Robert Wood Johnson Foundation says $580 more per visit). Also, the increased volume can be problematic for the hospital since many new insureds are covered by Medicaid and the hospital receives very low reimbursement for that care.

But we knew before ACA that we had a shortage of physicians. The feds projected a shortage of 20,000 primary care physicians by 2020. So how are these new insureds getting their care? Well, in the ER of course! Studies show that over 50% of ERs are experiencing increases in patient load – mostly in lower reimbursed Medicaid cases.

Didn’t we see this coming? An overworked system takes on significantly more work. This wasn’t hard to predict. It goes to the “false promise of the ACA,” said health care policy expert Avik Roy, that Medicaid recipients are “given a card that says they have health insurance but they can’t have access to physicians.”

Fixing these and other problems will be incredibly difficult given our political climate. The problems themselves are hard enough but navigating the political waters will be tougher. Buckle up. We’re in for a bumpy ride.

Call us. We can help you do better.