Failure of Obamacare Evidenced by Overcrowded Emergency Rooms


As a physician, I can attest to the recent article I’ve read in the Courier Journal about more people using the emergency rooms due to Obamacare. Unfortunately, under this new law, the newly insured Americans were supposed to be utilizing their primary care physicians instead of the emergency room. However, that has turned out certainly not to be the case.

With the number of visits to the ER soaring by the day, most ask why this rise is happening if more Americans are supposedly receiving coverage through Obama’s Affordable Care Act. The answer is actually simple. The health insurance that well over 50% people now covered by Obamacare received is Medicaid. Because there are too few primary care doctors actually accepting this insurance, these newly insured patients have no other place to go to see a physician other than the ER.

As stated in the Courier Journal article: “It’s a perfect storm here,” said Dr. Ryan Stanton of Lexington, president of the Kentucky chapter of the ER physician group. “We’ve given people an ATM card in a town with no ATMs.” In short, Obamacare provided millions with Medicaid, but there are no doctors accepting Medicaid.

The article went on to use Kentucky as an example. A workforce capacity study conducted for the state by Deloitte Consulting last year found that Kentucky needed 3,790 more doctors, including 183 more primary-care physicians, to meet pre-ACA demand. Under the law, it said the state may need to add an additional 284 primary-care physicians by 2017. Complicating matters, a quarter of Kentucky’s primary-care doctors could be ready to retire within five years, the report said. The report also said roughly 56 percent of the state’s primary-care physicians, and 22 percent of all physicians, accepted a Medicaid payment in 2011, which Deloitte said was its best estimate for figuring out how many physicians accept Medicaid.

While primary care may be difficult to find, emergency rooms cannot turn anyone away. Stanton said every patient who comes in must have a medical screening, and most doctors do more; “the vast majority … do treatment to decrease medical and legal risk.”

The problem gets even larger when you realize that Medicaid reimbursements are a fraction to that of Medicare. The physician reimburse is so low that a private practice doctor would go bankrupt if they only saw Medicaid patients. Between their overhead and malpractice, Medicaid reimbursements would not cover even the basic costs of doing business. In the end, there is no incentive for any private practice physician to accept Medicaid patients. Then, when you realize that reimbursements by the federal government for Medicaid are being cut, you will quickly realize that the number of physicians who accept it will also be dwindling.

So where does that leave those patients now? Worse off than they were before.

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