Right now, the flu season is quickly upon us and expected to peak in February of 2015. If you go to an average (non-affluent) emergency room during the next 2 months, you will probably find wall-to-wall patients waiting for hours to see a physician. Many may look as if they only have a few minor symptoms, such as sneezing or coughing. You may wonder why they don't just go see their own doctors.
However, they probably don't have "their own" doctors because they either can't afford insurance; or, can't afford to pay a large deductible; or, they have an insurance policy that leaves them with little access to doctors near their homes. As a result, they are forced to take advantage of a law in this country called the Emergency Medical Treatment and Active Labor Act (EMTALA). Under EMTALA, any hospital that takes Medicare patients must also take any patient regardless of their ability to pay or whether or not they are a U.S. citizen. Because of this law, and how ObamaCare addresses healthcare, a nightmare will be created in almost every emergency room that takes Medicare patients. So much so, that many hospitals may stop taking Medicare altogether in order to avoid having to take the millions of non-paying patients showing up at their doorsteps.
How ObamaCare will be responsible for this impending emergency room disaster comes down to two key elements of the law: (1) The Expansion of Medicaid and (2) high deductibles and high annual out-of-pocket expenses for insurance bought in the Exchanges.
First, there is the expansion of Medicaid. Medicaid was originally intended to give the poor access to healthcare at no cost; except for some token co-pays for certain services in certain states. ObamaCare changed that by allowing people who were 138% above the poverty threshold, access to Medicaid. This is a problem. Medicaid, as a wholly run state and federal, medical insurance program pays doctors and hospitals just a few cents on the dollar for the services they provide; and, almost every year, states have been cutting what doctors and hospitals are paid in order to balance their budgets. As a result, fewer and fewer are willing to take Medicaid patients. In a recent Merritt Hawkins report on healthcare in America, their most recent survey found that only 45.7% of the doctors surveyed would take Medicaid. This was down from 55.4% of doctors in 2009 and before the ObamaCare law was enacted. And, as the New York Times is reporting, that number may fall to as low as 40%.
So, if you can't find a Medicaid-accepting doctor near you, what do you do? Well, you go to the emergency room instead. Proof of this comes from Oregon who, in 2008, expanded Medicaid on its own. They surely thought that this would alleviate the overburdened emergency rooms in the state. However, just the opposite happened. ER usage rose by 40% because people were being forced off their own private insurances -- accepted by many doctors -- and onto Medicaid -- accepted by few.
Then, there's the health insurance being sold in the state and federal exchanges, and how they too will impact ER's across the country. All the policies being sold in the ObamaCare exchanges are primarily some form of catastrophic insurance; meaning they have high deductibles or high annual out of pocket expenses. For example, if you buy the cheapest plan, the Bronze plan, and whether or not the premiums are subsidized by the Federal government, you will still be liable for an average of $5,181 in annual deductibles. After paying that first, you will then pay 40% of any doctor/hospital bills (assuming the doctor/hospital treating you is even eligible for reimbursement under your exchange insurance plan's network) until you reach a maximum out-of-pocket limit of $6,373 per individual or $12,749 per family. So, if you are poor -- but not poor enough for Medicaid -- and, even if your premiums are fully subsidized by the Federal government, do you really think someone will simply go to a doctor and pay full-price for the doctor's bill and most likely some number of expensive tests that may be needed? No; instead you'll go to the emergency room of your nearest hospital and claim that under EMTALA you have no ability to pay. Of course, insurance bought in the exchanges have another problem similar to Medicaid: Fewer doctors are willing to accept ObamaCare insurance. This, too, will force many to go to ER's.
The bottom line is that millions of Americans getting insurance through ObamaCare, will still swamp our emergency rooms; forcing many to stop taking Medicare patients. Americans will literally die in the process for lack of quality care. And, the insurance premiums for those who can pay will skyrocket to make up for those who can't.
As Medicaid Rolls Swell, Cuts in Payments to Doctors Threaten Access to Care: http://www.nytimes.com/2014/12/28/us/obamacare-medicaid-fee-increases-expiring.html
New Study: Expanding Medicaid Reduces Access to Health Care: http://www.forbes.com/sites/aroy/2012/03/10/new-study-expanding-medicaid-reduces-access-to-health-care/
Merritt Hawkins: Survey 2014: Physician Appointment Wait Times and Medicaid and Medicare Acceptance Rates: http://www.merritthawkins.com/uploadedFiles/MerrittHawkings/Surveys/mha2014waitsurvPDF.pdf
Medicaid Expansion Boosted Emergency Room Visits In Oregon: http://www.npr.org/blogs/health/2014/01/02/259128081/medicaid-expansion-boosted-emergency-room-visits-in-oregon
Bronze Plan Statistics: http://www.healthpocket.com/individual-health-insurance/bronze-health-plans#.VKBUYv8LAB
Doctors Begin To Refuse Obamacare Patients: http://dailycaller.com/2014/08/04/doctors-begin-to-refuse-obamacare-patients/