NCPA - National Center for Policy Analysis

Obamacare Failed to Provide Individuals with Access to Affordable Care

May 20, 2015

One primary goal of the Affordable Care Act (ACA) was to expand access to affordable health care.

In order to pay for the subsidies that have facilitated the expansion of health insurance coverage, many recipients of federal funds were forced to accept payment reductions. Hospitals were faced with cuts of $260 billion over ten years.

Given that a large portion of the newly insured would gain coverage through Medicaid expansion and past reports have shown that Medicaid enrollees utilize the emergency room (ER) at higher rates than both the uninsured and the commercially insured, the assumption that fewer individuals would go to the ER to receive care by increasing insurance coverage to millions of people was not made on the most solid of grounds.


  • Growth in spending on physician and clinical services declined by roughly 1 percentage point from 2013 to 2014, despite growth in physician prices increasing during this period. This suggests a decrease in utilization of physician services.
  • Conversely, spending on hospital services increased by less than one percentage point from 2013 to 2014 even though growth in hospital prices actually decreased by nearly 1 percentage point.

New research regarding Medicaid expansion in California shows a direct correlation in increased visits to the ER from 2013 to 2014. Also, research done by athenahealth and the Robert Wood Johnson Foundation shows new-patient visits to primary care providers accounted for 22.9 percent of all visits to primary care physician offices in 2014, an increase of only 0.3 percentage points from 2013.

Five years after passage, the ACA has failed to reduce the cost of care and provide individuals with access to affordable care. Consequently, individuals continue to delay treatment or to seek care in the ER, both of which ultimately increase the cost of caring for such individuals.

Source: Tara O\'Neill, "Obamacare Failed to Address ER Overcrowding," American Action Forum, May 18, 2015.


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