How to Avoid the ER and Keep Health Costs Low

According to a new study published in the New England Journal of Medicine, the Affordable Care Act has helped thousands of young adults minimize health care treatment costs that come with a medical emergency. However, there’s no such thing as a free ride (especially in an ambulance).

Beginning in September of 2010, the Act required parents to cover the cost of their children’s health care until they’re 25 years old. Since then, more than 22,000 Americans between the ages of 19 and 25 have received coverage under the new policy.

This has saved an estimated $147 million in hospital charges, but of course parents are footing the bill for “children” who may have already graduated from college. According to a researcher at RAND Health, these young adults would otherwise be facing monstrous medical bills. But don’t the parents deserve some relief once a “child” is over the age of 18?

Saving hospitals and taxpayers money

If it weren’t for this provision of the Affordable Care Act, hospitals might just have to write off those unpaid bills. Depending on the state, the bill might even be passed to the taxpayers. Sometimes states step up to the plate to cover unpaid medical costs, because otherwise the entire health care system in the state will suffer. Along with requiring parents to cover children between 19 and 25, there’s also an insurance premium increase of about three percent after patients in that age group visit the ER.

The study reports that an additional 3.1 million young adults are now covered solely because of the provision. Researchers looked closely at ER visits for those ages 19-31 in 392 US hospitals between 2008 and 2011. To narrow things down even more, researchers only looked at injuries that required an ER visit; in other words, these people would have ended up in the ER whether they had insurance or not. The purpose of the Affordable Care Act is to improve financial protection in these situations.

The breakdown

True emergencies made up six percent of ER visits within the age range. Researchers compared those visits between two camps: patients 19 to 25, and those 26 to 31 (who weren’t affected by the provision). Overall, researchers indeed found greater financial protection, since these 19- to 25-year-olds would have gone to the ER in any case, but would have incurred steep medical bills.

Some critics are more interested in the 94 percent of people going to the ER who didn’t need to. Is the provision encouraging people to take up valuable ER resources when they’re more suited to urgent care treatment or even a doctor’s appointment? Wouldn’t it be better if these young adults bought their own coverage?

There’s no doubt that personal health insurance is expensive. The “best insurance” is available through certain employers, but many young adults have trouble finding a good job with benefits. When shopping for health insurance, always shop around, compare policies, and inquire about discounts. Every insurance company offers different rates for the same coverage, so research and probing are necessary.

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