With Medicaid cuts, hospital emergency rooms could get even busier

Healthcare leaders have warned that if millions lose coverage due to cuts in Medicaid, then many Americans are going to show up in hospital emergency rooms when they’re sick.

Hospital emergency departments are likely to see more patients in the wake of millions of Americans losing Medicaid coverage, healthcare leaders say.

The Senate narrowly approved a tax and spending package Tuesday that healthcare leaders say would deprive millions of Americans coverage. An estimated 11.8 million Americans would lose Medicaid coverage over the next 10 years, according to projections from the nonpartisan Congressional Budget Office.

The American College of Emergency Physicians warns that the significant reductions in Medicaid coverage “will have dangerous ripple effects that impact anyone in need of lifesaving emergency care.”

Many hospitals have said they have seen more patients in emergency departments in recent years, due to a lack of available inpatient beds in hospitals, including beds for those who need psychiatric care.

“Emergency care teams are already strained to their limits under factors outside of their control,” the group said Tuesday.

“The additional strain that this bill will impose by substantially increasing the number of uninsured or underinsured individuals will result in millions of patients with no other option to access care than the emergency department, further crowding already overburdened EDs, delaying care, and driving up costs for everyone,” the organizaton said.

Ryan Oglesby, president of the Emergency Nurses Association, said hospitals could see more volume even as they have fewer resources. Medicaid is the most common form of health insurance among patients in emergency departments, he noted.

“Emergency departments play a vital role as a health care safety net,” Oglesby said in a statement Tuesday. “However, Medicaid cuts of this magnitude will hurt Americans in need of medical coverage and hinder the ability of dedicated emergency nurses and other health care workers to provide the best care possible while further straining their well-being and morale to continue doing their vital work.”

Rick Pollack, president and CEO of the American Hospital Association, has repeatedly warned that hospital emergency rooms will be packed with more patients if there are significant reductions in the number of people covered by Medicaid.

When the Senate introduced its tax proposal in June, Pollack said, “These cuts will strain emergency departments as they become the family doctor to millions of newly uninsured people.”

Hospital leaders have said that other elements of the package, including reductions on provider taxes that help states pay for Medicaid programs, could lead to some hospitals shutting down. If hospitals close, that would add to the strain of other nearby facilities, especially in the emergency department.

Erik Wexler, president and CEO of the Providence health system, said in a news conference last month that some patients losing access to primary care coverage could end up in emergency rooms with more advanced illness.

“When Medicaid suffers, the entire country suffers, because people that are dependent on having access for preventative care need this type of coverage so that they don't get sicker and wind up in our emergency departments and in our ICUs,” Wexler said.

Hyun Namkoong, deputy director of health advocacy for the North Carolina Justice Center, raised concerns about hospitals seeing sicker patients if fewer people have Medicaid coverage.

“We would see rural hospitals close, and then emergency rooms get flooded by folks who have waited too long to get care,” Namkoong said in a news conference held by Families USA Monday.

The measure still must go back to the House of Representatives before it can go to President Trump. But the White House has set a July 4 deadline.

The American College of Emergency Physicians and other healthcare advocacy groups are urging House and Senate leaders to make changes to the package. Emergency doctors note that they are legally obligated to treat all patients, regardless of their ability to pay.

“We will, as we always do, continue to uphold this commitment,” the ACEP said. “However, the impact of these massive changes to Medicaid will hinder our ability to provide timely care today and will reverse years of important progress in increasing access to health coverage.”