#Obamacare success story full#

#Obamacare success story full#

That study, conducted prior to Obamacare’s full implementation, compared the results and behavior of a group of individuals randomly selected to participate in Medicaid expansion in that state to individuals who did not participate in the expansion. The California study echoes similar findings from the Oregon Health Insurance Experiment several years ago. California Study Echoes Oregon ‘Experiment’ That inconvenient truth might explain why the California Health Care Foundation didn’t highlight the impact of Medicaid, or Obamacare’s expansion of it, in the report itself. To put it bluntly, the raw data from the California study suggest the state has less of a problem with an overall increase in ER visits and much more of a problem with an explosion in Medicaid patient ER visits. While private patients’ ER usage held relatively flat over the decade, the nearly 4 million increase in ER visits by Medicaid patients swamped the combined 863,000 fewer visits by self-pay and uninsured patients and patients with other coverage. Translating the percentages into specific numbers makes the story clearer, as nearly 90 percent of the increase in the number of ER visits from the years 2006 through 2016 comes from Medicaid patients: However, the 20 percentage point increase in ER visits by Medicaid patients (California calls its Medicaid program “Medi-Cal”) more than outweighs the 9 percentage point decline in self-pay and uninsured patients and the 4 percentage point decline in patients with other forms of coverage. Unfortunately, this chart does not reveal data for the years immediately before and after Obamacare implementation in 2014, making it tougher to draw direct conclusions. From 2006 through 2016, Medicaid patients nearly doubled as a share of ER visitors, while ER visitors with private insurance and no insurance both declined: The study indicates that ER usage accelerated in the years immediately following Obamacare’s implementation, just as it shows Medicaid patients comprised a larger share of ER visits. By comparison, in the six years from 2008 through 2013 - a period coinciding with the Great Recession, which saw many Americans lose their jobs, and with it their employer-sponsored health insurance - ER visits rose by only 38 per 1,000 patients. In the four years from 2013, the year before Obamacare’s full implementation, through 2016, ER visits rose by 39 per 1,000 patients. But examining the numbers at the bottom of the chart, which track visits per 1,000 individuals - a metric that adjusts for changes in the state’s population - demonstrates the impact of Obamacare. The chart shows a trend line of generally increasing ER usage throughout the decade. While the report, perhaps quite deliberately, didn’t highlight this conclusion - it mentioned Obamacare once, and only in passing - the data indicate that emergency department usage since Obamacare has not only not decreased, it has accelerated, rising at a faster rate than in prior years. The study, conducted by the California Health Care Foundation, examined emergency department usage over the ten years from 2006 to 2016. Emergency Rooms Are Getting More, Not Less, Use These make a study published last week casting doubt on whether California has delivered on one of its central promises of particular note. Whether explicit or implicit, these and articles like them have presented a consistent theme: Absent Republican “ sabotage” - less present in a Democratic-dominated state like California - Obamacare would have delivered on its promises much more effectively.