Policy

The Doctor Will Not See You Now

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One of ObamaCare's major promises was that it would increase access to health care, and, in particular, that it would help unclog the nation's crowded hospital emergency rooms. In fact, there's mounting evidence that the crowds—and the wait times that go with them—will grow larger: In Massachusetts, for example, emergency room wait times rose 7 percent between 2005 and 2007. Last year, USA Today reported that the state capitol, Boston, had the highest wait times in the country. Many experts expect to see wait times increase across the nation under the PPACA. As John Goodman of the National Center for Policy Analysis explains at Health Affairs, the issue isn't the uninsured. Instead, it's Medicaid, the health care program for those with low incomes.

The use of the emergency room by uninsured patients is not that much different than usage by the insured. The heaviest users of the ER (in proportion to their numbers) are Medicaid patients, probably because Medicaid rates are so low that physicians are not anxious to see them. And the reason why that is important is that more than half of the people who gain insurance under the new health reform bill will enroll in Medicaid.

The Congressional Budget Office estimates that the PPACA will add 16 million new individuals to Medicaid. And that almost certainly means many, many more emergency room visits. ObamaCare was sold as a way to ease America's health care burdens. Instead, it looks more and more like its legacy will be to increase the strain on a broken system.