Study: Expanded insurance coverage alone may not mean better access to care

The goals of the ACA include improving health insurance coverage, reducing health care costs and expanding access to care for millions of Americans. But a study by the University of Colorado School of Medicine published in the Archives of Internal Medicine shows expanded insurance coverage alone may not mean better access to care.

"Massachusetts enacted legislation similar to the Affordable Care Act in 2006, but data show despite nearly 98 percent health insurance coverage, emergency department visits remained high and one main reason was limited access to primary care," said Adit Ginde, MD, MPH, senior author of the study, assistant professor of emergency medicine at CU School of Medicine and emergency department physician at University of Colorado Hospital (UCH).

Ginde and his co-authors, Paul Cheung, MPH, and Jennifer Wiler, MD, MBA, analyzed National Health Interview Survey data of approximately 317,000 adults across the United States from 1999 to 2009. They found that people with one or more barriers to primary care are more likely to visit the emergency department and that barriers to primary care have doubled over the past decade. Those barriers include: limited physician office hours, wait times for appointments, difficulty in getting in touch with a primary care physician's office to make an appointment and transportation issues.

"In addition to expanding health insurance coverage, policy makers may need to address the shortage and availability of primary care physicians. Without adequate primary care access, many people will continue to require emergency services and emergency departments will only continue to get busier and more crowded," said Ginde.