Despite the projections of ex-Massachusetts Republican Governor Mitt Romney, emergency room (ER) usage increased under Massachusetts 2006 Massachusetts health care reform law, RomneyCare. The data comes from a presentation given by former Massachusetts Democratic State-Senate candidate, Dr. Peter Smulowitz, who is also and more impressively an ER physician and lecturer at Harvard. However I am quoting below only the raw data Dr. Smulowitz discovered and reported using state sources. He emphasized to me in an email that the slicing and dicing and regressing of the data he presented is not complete.
Preliminarily Dr. Smulowitz thinks the increase was not as much as predicted by some experts prior to the passage of RomneyCare. He’s still number crunching to see if the rise was statistically significant or simply a matter of the time slices selected. However, the raw data is of interest to me because THE expert behind this disaster called RomneyCare – Romney himself – was wrong. Romney predicted the number would decrease based on his reform. Remember, Romney’s stated objective was to get the free riders using ERs out of the ER by forcing them to buy health care insurance (see particularly the "Appropriate Care..." paragraph in the linked November 2005 Boston Globe op-ed by Governor Romney).
Dr. Smulowitz looked at two groups, adults over 65 and adults under 65 (picked so that the Medicare patients – unaffected by RomneyCare -- would act as a control group), for the years 2005 and 2009 (picked because of the intervening 2006 passage of RomneyCare). He found:
“For adults under age 65, ED visits increased from 1,970,976 in 2005 to 2,279,492 in 2009… Adults older than 65 years had 450,933 ED visits before reform and 470,109 ED visits after reform…”
That’s an increase of 16% among the newly insured so-called free riders, the group that was supposed to experience a drop, versus an increase of a noise-level 4% among the group that had insurance all along, those on Medicare. (Hopefully as part of his ongoing slicing and dicing, Dr. Smulowitz is accounting for the fact that some number of people who were aged 60-64 in 2005 and uninsured became over 65 and insured by Medicare by 2009. That demographic change alone might account for the 4% increase.)
Either way, the number of ER visits clearly didn’t go down, Mitt.
-- Dennis Byron
