Improved Access to Health Insurance Is Not a Panacea for Preventing ED Visits for Low-Acuity Illness

In 2006, Massachusetts enacted legislation that required residents to acquire health insurance. Within 2 years, nearly half a million people were newly insured, 70% of them though the state's Medicaid program. Using data from a convenience sample of 11 Massachusetts hospitals, researchers compared differences in emergency department (ED) use for low-acuity illness before and after enactment of the legislation between patients who were uninsured/underinsured and those who were insured.

Overall, ED visits increased by 4.1% between the year before enactment and 2008 (2 years after enactment). Low-acuity visits as a proportion of total visits decreased among uninsured/underinsured patients (from 43.8% to 41.2%) and among insured patients (from 3…