More Insured Americans (and More ED Visits) Since the Advent of ‘Affordable Care’

The stated intention of the Affordable Care Act was to move the U.S. to a nation in which healthcare insurance was available to every citizen. Part of the subtext for its effect on the healthcare system was that if everyone had access to traditional health insurance, more people would engage in preventive healthcare, leading to lower need for emergency room visits and associated costs. That cause-and-effect has yet to be realized, however. While 20 million more Americans have health insurance since the ACA (also known as Obamacare) was signed into law in 2010, overall ED visits have continued to climb, according to a study just published in JAMA Network Open. In effect, the only thing that’s changed is that more of the people going to the ED are insured—which is of questionable value to the overall health system. These data illustrate two things: 1) The ACA has been a mixed blessing and 2) There are still more benefits to be realized from increased use of urgent care, which continues to offer many of the same benefits as care in the ED at a fraction of the cost and with greater convenience. Fortunately, other studies continue to show urgent care visits are also on the rise—validation that the industry’s efforts to spell out the benefits to both patients and payers is paying off.