While the Medicaid expansion may lead to a dramatic rise in emergency room use and hospitalizations for many of the previously uninsured, that increase is largely temporary and should not lead to a dramatic impact on state budgets, according to a new analysis from the UCLA Center for Health Policy Research released Wednesday.
Researchers reviewed two years of claims data from nearly 200,000 Californians who had enrolled in public programs in advance of the expansion of Medi-Cal, the state's version of Medicaid, in January. These programs were designed to ease the expansion of Medicaid by providing insurance to low-income adults who were not eligible for Medi-Cal at that point but would be when the health law's expansion went into effect earlier this year.
Researchers then divided the group into four categories, based on the researchers' assessment of each group's pent-up demand for health care.
In July, 2011, after being enrolled in California's Low Income Health Program, the so-called "bridge to reform," the group with the highest pent-up demand had a rate of costly emergency room visits triple -- or more -- that of the other groups. But from 2011 to 2013, that high rate dropped by more than two-thirds and has remained "relatively constant," according to the analysis.
"We were hoping that this would be the case," said lead author Jerry Kominski, director of the UCLA Center for Health Policy Research, "because we think that that's what access to care does for low-income individuals … that there's an additional increase in demand for services and that that demand, or utilization, drops off pretty rapidly."