The report—commissioned by the Emergency Medicine Action Fund  (EMAF)—is titled “Review of the Evidence on the Use of the Emergency Department by Medicaid Patients and the Evolving Role of Emergency Medicine Physicians” [PDF].

“America has severe primary care physician shortages, and many physicians will not accept Medicaid patients because Medicaid pays so inadequately,” said Dr. Gerardi. “Just because people have health insurance does not mean they have access to timely medical care.”

In addition, Dr. Gerardi raised concerns about the closure of hospitals and emergency departments in states that have not expanded Medicaid.

“Hospitals received less Medicaid funding for charity care when the ACA took effect, because more people were supposed to have health insurance coverage,” said Dr. Gerardi. “But in states that didn’t expand Medicaid, hospitals are hurting. For example, the closure of a hospital in Baton Rouge resulted in a crisis for another hospital that inherited all the patients, many of whom are uninsured, and now this hospital may close as well. The average reimbursement for a Medicaid patient in the ER is about $43.00, but it’s much lower in many states.”

When asked what would happen if federal subsidies for health insurance coverage were to be eliminated in their states—which might occur  if the U.S. Supreme Court decides in favor of the plaintiff in King v. Burwell—42 percent of emergency physicians said they expect emergency visits to increase. Additionally, 65 percent expect reimbursement for emergency care will decrease if those federal subsidies are eliminated.