Among individuals without stable insurance coverage, emergency departments are often the healthcare safety net of last resort — and upcoming cuts to Medicaid could put EDs under more strain.
The One Big Beautiful Bill Act, signed into law July 4, curbs Medicaid spending by $1 trillion through 2034, which is expected to contribute to 11.8 million people without health insurance coverage within the next decade. States already experiencing high ED utilization could face greater strain as more residents without insurance turn to the ED for non-routine or delayed care.
KFF analyzed 2023 community hospital data, the most recent available, from the 1999-2023 American Hospital Association Annual Survey, and compared it to population reports from the Census Bureau.
Here are the states and the District of Columbia ranked by total hospital ED visits per 1,000 population:
West Virginia: 596
North Dakota: 591
Louisiana: 589
Mississippi: 567
Maine: 555
Ohio: 541
Indiana: 539
Kentucky: 514
Missouri: 511
District of Columbia: 500
Pennsylvania: 489
Nebraska: 486
Connecticut: 481
Massachusetts: 473
Tennessee: 468
Arkansas: 466
Rhode Island: 464
Florida: 455
New York: 452
New Hampshire: 446
Kansas: 444
Michigan: 444
Vermont: 439
Delaware: 438
Oklahoma: 437
North Carolina: 432
Virginia: 429
United States: 422
South Carolina: 418
Texas: 416
Illinois: 412
Colorado: 409
Idaho: 407
Alabama: 402
New Mexico: 402
Wyoming: 394
Georgia: 392
Montana: 388
Iowa: 387
Oregon: 386
Wisconsin: 384
South Dakota: 370
New Jersey: 369
Washington: 366
Minnesota: 352
California: 346
Hawaii: 333
Maryland: 303
Utah: 287
Arizona: 281
Alaska: 258
Nevada: 226
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