In some ways, the United States has always had universal health care. After all, the ER is always obligated to treat patients who come through their doors, no matter how trifling the condition.
While universal health care that is paid for remains an elusive goal, new research suggests the Patient Protection and Affordable Care Act has led to a sharp decrease in the amount of uncompensated care in U.S. hospitals.
After examining hospital discharge data in 21 states, Dr. Katherine Hempstead of the Robert Wood Foundation and Dr. Joel Cantor of Rutgers University found that states that expanded Medicaid dramatically reduced the number of patients receiving uncompensated hospital care.
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In the 11 states studied that expanded Medicaid, the number of inpatient hospital admissions of "self-pay" patients, who either paid for their care out-of-pocket but often likely didn't pay at all, dropped a whopping 36.4 percent between 2013 and 2014. In the 10 other states, which didn't expand Medicaid, the number of self-pay patients only dropped 9.8 percent.
In the emergency departments, the difference between the two sets of states was less dramatic but significant nonetheless. In expansion states, "self-pay" emergency care dropped 28.4 percent, while in non-expansion states the rate only dropped 8.4 percent.
"These results suggest that Medicaid expansion may have important effects on the payer mix, primarily by reducing the volume of uncompensated care," the report concluded.
The decline in uninsured care coincided with a logical increase in care covered by Medicaid. However, the two figures weren't perfectly correlated. In expansion states, Medicaid-covered care rose by 9.6 percent for inpatient admissions and 21.3 percent in the emergency room, changes that weren't as dramatic as the drop in uninsured care in both cases.
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