Medicaid Cuts Could Burden EDs with More Uninsured Patients
Abstract
Proposed federal cuts in state Medicaid programs and lowered state support of the touted Children's Health Insurance Program would not increase the number of patients seeking emergency care, but it could mean more of them will be uninsured. That would shift the cost of their care from the federal arena to state and local entities, according to a new study. (Health Affairs 2006;25[1]:237.) “There isn't much of a change in the overall number of emergency department visits, but there is more of a shift in terms of an increase in the number of uninsured going to the emergency department. And the implication of that is to increase uncompensated care in hospitals as well,” said Peter Cunningham, PhD, a senior health researcher at the Center for Studying Health System Change in Washington, D.C. His study projected what could happen if proposed cuts and changes in the Medicaid/SCHIP programs take effect. “The recent budget reconciliation bill has some provisions that could result in decreases in enrollment,” Dr. Cunningham said, noting that states will be allowed to shift more of the burden of paying for Medicaid to enrollees by charging premiums or increasing co-pays. That would not only increase financial burdens on the enrollees, but also could cause some of them to drop out, he said. A requirement by states to prove citizenship with a birth certificate or passport also could deter enrollment, and large cuts of as much as 25 percent already have been made in states such as…
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