Proponents of the Affordable Care Act, informally known as Obamacare, have argued that as health care coverage becomes available to more Americans; costs will plummet as people begin taking advantage of less costly preventive and primary care services. A paper published last month in the journal “Science” suggests the expansion of health care coverage under the Affordable Care Act has had the opposite effect.
ER Visits Go Up When People Are Covered
The study, conducted by researchers from MIT, Harvard, the Providence Portland Medical Center, Columbia and the National Bureau of Economic Research, examined the effects of a limited Medicaid expansion instituted in Oregon in 2008. The researchers found, contrary to expectations, expanding access to Medicaid increased emergency room visits by 40 percent. The researchers examined hospital records from 25,000 new Medicaid beneficiaries — and discovered medical costs increased across all age and ethnic groups.
It wasn’t just ER visits that shot up. The study authors found new Medicaid recipients were using more primary care facilities, too; they began seeing the doctor more often in addition to using the ER more frequently. Nor did the added health care seem to measurably improve the Medicaid recipients’ health. They continued managing their chronic conditions, like high cholesterol, hypertension and diabetes, about as well as they had before.
It’s important to note the study only examined the health care consumption habits of new Medicaid recipients in the state of Oregon for the first 18 months after that state’s Medicaid expansion. We do not know how the new Medicaid recipients may have changed their health care consumption patterns since the study ended. With time, it’s possible the Medicaid recipients’ reliance on the ER has gone down, now that they’re more accustomed to using primary and preventive care services for the bulk of their health needs.
It makes sense that more people are seeking medical care now that the ACA has made health coverage more affordable for many Americans. The hospital emergency room is the most expensive form of medical care, a contributing factor in increased medical spending among the study participants. An ER visit can cost $300 to $1,000, compared to $65 to $75 for a primary care visit.
Saving Money on Medical Expenses
The easiest way to save money on medical costs is to take advantage of free preventive care services. Under the ACA, insurance providers are now required to cover the cost of a number of preventive procedures ranging from annual wellness exams to blood work and cancer screenings.
The benefits of preventive health care are well-documented. Preventive care allows you to catch chronic health conditions while they’re still in their earliest stages. That makes them easier to treat or stave off entirely.
Plus, getting your preventative care saves you — and your insurance company — money in the long run. Diabetes screening tests, for example, are one of the preventive services now available for free under the ACA. If you receive this test and are found to be pre-diabetic, you and your health care provider could work together to help you lower your blood sugar and stop you from developing full-blown diabetes using diet and exercise alone. Both you and your insurance provider would save the costs of diabetes medication and even more expensive interventions designed to treat the debilitating and life-threatening complications of diabetes. In general, the earlier you can treat a chronic health condition, the cheaper that treatment is for both you and your insurance provider.
Preventative care can’t protect you from all medical conditions, unfortunately. Medical emergencies are the biggest financial drain for most families. Know the terms of your insurance policy and keep on top of any changes. In an emergency, you want to make sure you’re going to an in-network hospital. You should also be aware of any alternative therapy, dental care or wellness programs you’re entitled to under your insurance policy.
Another way to save on medical expenses is to buy generic drugs when you can; they’re much cheaper than brand-name drugs and work just as well. You can get a discount on prescription drugs like Enoxaparin when you buy them from a Canadian pharmacy.
Haggling Can Work
Don’t be afraid to haggle when it comes to medical care, either. Get the Current Procedural Terminology (CPT) code for any test or procedure you need, then call around to find out what different hospitals in your network are charging for that procedure. Be honest with your care provider about what you can and can’t afford. If you make it clear that you can only afford to pay a certain amount, the hospital will be more likely to come down. After all, they want to get at least some of their money.
The ACA is raising medical costs for insurers more than expected, and some of that cost could end up getting passed down to you, the consumer. Fortunately, there are steps you can take to slash your medical expenses.
About the Author: Dr. Rodney Sewell lives and works in Atlanta. He dispenses his medical knowledge via articles and blogs when not working at his practice.