The number of uninsured patients who were hospitalized or visited the emergency department declined after 2014, when many of the ACA's insurance provisions were implemented, according to a study published in JAMA Network Open.
For the study, ED researchers from Stony Brook (N.Y.) University and Canton, Ohio-based US Acute Care Solutions examined how ACA provisions like Medicaid expansion, the individual mandate and private insurance exchanges affected hospital and ED visits among America's uninsured population. The study authors analyzed National Hospital Ambulatory Care Survey data and Healthcare Cost and Utilization Project data from 2006 to 2016.
In their cross-sectional analysis of 1.4 billion ED visits within the study period, the researchers found uninsured ED visits fell from 16 percent to 8 percent after the 2014 ACA insurance expansions. Comparatively, after analyzing 405 million hospital discharges within the study period, the authors found uninsured hospital visits fell from 6 percent to 4 percent.
However, the researchers said: "Despite these changes, approximately 1 in 10 ED visits and 1 in 20 hospital discharges were made by uninsured individuals in 2014 to 2016. This suggests that continued attention is needed to address the lack of insurance in U.S. hospital visits, particularly among people aged 18 to 64 years who have less access to government-sponsored insurance."
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