HealthDay News – In the first year of Medicaid expansion there were changes in the insurance status and location of emergency department visits, according to a study published online in the Annals of Internal Medicine.

Craig Garthwaite, PhD, from Northwestern University in Evanston, Illinois, and colleagues examined the effect of the 2014 ACA Medicaid expansion on the location, insurance status, and type of emergency department visits in a quasi-experimental observational study. They compared changes from the end of 2013 to the end of 2014 for patients from Medicaid expansion vs non-expansion states.

The researchers found that there were 1.06 million emergency department visits among patients from 17 states with Medicaid expansion and 7.87 million visits among the 19 states without expansion. There was an overall 47.1% decrease in uninsured visits in the emergency departments treating patients from Medicaid expansion states, and a 125.7% increase in Medicaid visits after 12 months of ACA expansion. 

There was a 0.9-minute decrease in the average travel time for nondiscretionary conditions requiring immediate medical care among all Medicaid patients from expansion states. Little evidence of similar changes was seen from non-expansion states.

“Meaningful changes in insurance status and location and type of emergency department visits in the first year of ACA Medicaid expansion were found, suggesting that expansion provides patients with a greater choice of hospital facilities,” the authors wrote.


Garthwaite C, Gross T, Notowidigdo, Graves JA. Insurance expansion and hospital emergency department access: evidence from the Affordable Care Act [Published online December 20, 2016]. Ann Intern Med. doi:10.7326/M16-0086.