Is Obamacare to Blame for Sick Nation?

by Gavin Magor | May 11, 2015

It doesn’t matter if you support Obamacare or wish national healthcare would just go away. Whichever side you’re on, it’s important to know what’s actually happening.

On this fifth anniversary of the Affordable Care Act, or Obamacare, we look at different aspects of use of health insurance to see what’s really going on.

So, here are vital statistics. Doctor visits have gone up with the implementation of Obamacare. And, days spent in the hospital have gone up too.

Is this a sign we are a sicker nation or are there just more of us using insurance coverage?

If you’re in the pro Obamacare camp, you probably think the increase in usage makes sense since there are more people covered by insurance. And, if you’re on the anti Obamacare side, you’re probably thinking it’s just as you expected – more people will overwhelm the U.S. healthcare system and make it more expensive for everyone.

So, who’s right? It seems there is truth for both sides.

Five years into Obamacare, there is no doubt more people have and are using their insurance coverage.

In fact, there were 21.5 million more people covered by health insurance in the third quarter of 2014, compared with the first quarter of 2010 according to a Weiss Ratings analysis of the data filed by over 1,500 insurers with the National Association of Insurance Commissioners (NAIC).

Clearly, many of those people went to a physician and the number of visits increased from 198.8 million visits during the first quarter of 2010 to 231 million visits during the third quarter of 2014. That's an increase of 32.2 million or 16 percent.

And for hospital visits, Weiss Ratings analysis shows that, on a rolling twelve-month average, in the first quarter of 2010 there were 9.2 patient-days per hundred insured. In the third quarter of 2014, this number was 10.8 patient-days per hundred insured.

So, are these increases an indication of the success or failure of Obamacare?

Given the dire projections, the 32.2 million actual additional visits to a physician represent a more modest increase than anticipated. Quarterly physician visits increased 3 per hundred insured since Obamacare became law based on a rolling twelve-month average. This latest number, of 127.5 visits per hundred insured, is well within the peak of visits during this five year period when visits spanned from 134.7 visits per hundred during the fourth quarter of 2011 to the lowest at 117.6 visits during the second quarter of 2013.

Inevitably, if the number of physician visits and days spent in a hospital continue to increase, the additional expense is likely to result in higher health insurance premiums. This rise in premiums was discussed in an earlier Weiss article, Obamacare: Enrollment and Cost of Health Insurance.

However, it appears that, excluding a recent rise in hospital patient days for those with group coverage, the real growth in patient hospital days is driven by Medicaid. Although the expansion of Medicaid was a key component of the ACA as can be seen in the graphic below the trend appears driven by a general growth over five years not just Obamacare.

Patient-days per hundred for those with Medicaid coverage, on a rolling 12-month average, rose from 12.5 days in the first quarter of 2010 to 20.1 days in the third quarter of 2014. That represents a very significant 60.7 percent increase, in less than five years.

The importance of this upward hospital usage trend should not be under-estimated. And the growth in costs cannot be blamed entirely on Obamacare. Instead, increased hospital utilization and consequently costs, appear to be the result of both a political failure to pass legislation such as the Community Living Assistance Services and Supports Act (CLASS) to provide adequate care for the rapidly needy Baby Boomer generation along with the inability of private insurers to price long-term care affordably and profitably for the growing need.

Inevitably, if health expense issues, which were a major exclusion from Obamacare, are not addressed, prices will continue to rise. And that means costs for consumers will get a lot worse before they get better.

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