Emergency rooms help uninsured get coverage


Hospital emergency rooms have become the new front line of Affordable Care Act enrollment, reported Kaiser Health News in collaboration with National Public Radio. The article profiled O'Connor Hospital in San Jose, Calif., which used state exchange funds to create a health benefits resource center near its ER to help thousands of uninsured patients apply for coverage.

Hospitals have a great deal of skin in the ACA enrollment game. When formerly-uninsured patients qualify for subsidized private coverage, new sources of revenue open as hospitals face Medicare payment cuts. And as Medicaid expands its beneficiary base in 26 states, hospitals may collect retroactive payment for services dating back three months, the article noted.

O'Connor Hospital President and CEO Jim Dover told KHN and NPR he welcomes the idea of fewer uninsured people visiting the ER for primary care, which drives up overall healthcare costs. And Renee Hsai, associate professor of emergency medicine at the University of California San Francisco, described the ER as "one of those places where you have low-hanging fruit." She added, "And if they're waiting, they [uninsured patients] might as well be filling out some application form, or at least learning about the process."

But people may not be clear-minded or motivated enough to start the enrollment ball rolling as they wait for ER care. Moreover, "most patients remain thoroughly befuddled about the law," the article said, echoing news that many uninsured Americans don't know about ACA subsidies, newly-available plans or the open enrollment deadline, as FierceHealthPayer reported.

This makes customer educational outreach increasingly important. However, the climate is hostile to effective advocacy in some places, as navigator laws in some states block consumer insurance access, and advocates face obstacles assisting people in rural communities.

For more:
- read the KHN and NPR article

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